Effectiveness of Monovalent Rotavirus Vaccine (Rotarix) against Severe Diarrhea Caused by Serotypically Unrelated G2P[4] Strains in Brazil
Effectiveness of Monovalent Rotavirus Vaccine (Rotarix) against Severe Diarrhea Caused by Serotypically Unrelated G2P[4] Strains in Brazil
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DOI：
10.1086/649843
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发表时间：
2010-02-01
影响因子：
6.4
通讯作者：
Nakagomi, Toyoko
中科院分区：
文献类型：
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作者：
Correia, Jailson B.;Patel, Manish M.;Nakagomi, Toyoko
背景资料。在拉丁美洲的一项试验中，一种单价G1P[8]轮状病毒疫苗显示出对严重轮状病毒腹泻的高效疗效。对血清型无关的G2P[4]菌株的保护力较低，这些菌株很少传播。这项病例对照研究是为了评估这种单价G1P[8]轮状病毒疫苗在巴西对抗G2P[4]株的有效性。病例患者是2006年3月至2008年9月在巴西累西腓一家医院就诊的患有严重G2P[4]轮状病毒腹泻的儿童。在控制出生月份和年份后，病例患者的疫苗接种率与2组对照参与者-轮状病毒阴性腹泻儿童和因急性呼吸道感染(ARI)住院的儿童-的疫苗接种率进行比较，以计算疫苗效果。我们招募了70名G2P[4]轮状病毒阳性的严重腹泻患者，484名轮状病毒阴性的腹泻对照患者，以及416名ARI的对照参与者，年龄=6个月。在6-11个月大的儿童中，轮状病毒阴性的腹泻对照组和ARI对照组的G2P[4]腹泻疫苗的有效率分别为77%(95%可信区间[CI]，42%-91%)和77%(95%可信区间，43%-90%)。在腹泻和急性呼吸窘迫综合征轮状病毒阴性对照组中，12个月龄儿童的疫苗有效率分别降至-24%(95%CI，-190%~47%)和15%(95%CI，-101%，)。这种单价G1P[8]轮状病毒疫苗对6-11个月儿童的严重G2P[4]轮状病毒腹泻有效。在12个月大的儿童中，疗效下降，这表明免疫力正在减弱。
Background. In a Latin American trial, a monovalent G1P[8] rotavirus vaccine showed high efficacy against severe rotavirus diarrhea. Protection was lower against serotypically unrelated G2P[4] strains, which circulated infrequently. This case-control study was undertaken to assess the effectiveness of this monovalent G1P[8] rotavirus vaccine against G2P[4] strains in Brazil.Methods. Case patients were children with severe G2P[4] rotavirus diarrhea who presented at a hospital in Recife, Brazil, from March 2006 through September 2008. Vaccination rates among case patients were compared with rates among 2 groups of control participants-children with rotavirus-negative diarrhea and children admitted for acute respiratory tract infection (ARI)-to calculate vaccine effectiveness, after controlling for the birth month and year.Results. We enrolled 70 G2P[4] rotavirus-positive case patients with severe diarrhea, 484 rotavirus-negative control participants with diarrhea, and 416 control participants with ARI, aged >= 6 months. Among children aged 6-11 months, the effectiveness of the vaccine against G2P[4] diarrhea was 77% (95% confidence interval [CI], 42%-91%) and 77% (95% CI, 43%-90%) among the rotavirus-negative control participants with diarrhea and control participants with ARI, respectively. Vaccine effectiveness in children aged >= 12 months decreased to -24% (95% CI, -190% to 47%) and 15% (95% CI, -101 to 64) among the rotavirus-negative control groups with diarrhea and ARI, respectively.Conclusions. This monovalent G1P[8] rotavirus vaccine was effective against severe G2P[4] rotavirus diarrhea among children aged 6-11 months. Effectiveness declined among children aged >= 12 months, which suggests waning immunity.