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Oishi T, Hasegawa S, Nakano T, Sudo S, Kuwajima H, Tokuriki S, Tamura T. Changes in vaccine coverage and incidence of acute gastroenteritis and severe rotavirus gastroenteritis in children <5 years in Shibata City, Niigata Prefecture, Japan. Hum Vaccin Immunother 2024; 20:2322202. [PMID: 38478958 PMCID: PMC10939147 DOI: 10.1080/21645515.2024.2322202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 02/20/2024] [Indexed: 03/17/2024] Open
Abstract
Rotavirus (RV) vaccines were first introduced in 2011 and adopted for universal vaccination in 2020 in Japan. However, the effectiveness of RV vaccines after being adopted for universal vaccination in 2020 has not been reported. Because of the easy accessibility of clinics in Japan, many children are not usually hospitalized for RV gastroenteritis (RVGE). Therefore, in order to evaluate the impact of the RV vaccine since 2008, we investigated the incidence of hospitalization for RVGE as well as the frequency of children aged < 5 years who received medical treatment for severe RVGE at clinics in Shibata City, Japan. The RV vaccine coverage rate was 94.0% (1,046/1,113) in Shibata City after universal vaccination in 2020; this was a significant increase from previous rates. The incidence per 1000 person - years for RVGE hospitalization and severe RVGE at clinics were significantly higher among children aged < 3 years than in previous time periods. The incidence in children with all acute gastroenteritis (AGE) decreased significantly after universal vaccination during the COVID-19 pandemic. The proportion of severe RVGE among all AGE cases also decreased significantly after universal vaccination among children aged < 3 years (0.0%) and those aged 3-4 years (0.6%). There were significant differences in the distribution of RV genotypes isolated from the feces of children with RVGE between different eras divided by RV vaccination rates, especially G1P[8], which was the major genotype before it recently almost disappeared. Further studies are warranted to assess the impact of the COVID-19 pandemic.
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Affiliation(s)
- Tomohiro Oishi
- Department of Clinical Infectious Diseases, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Satoshi Hasegawa
- Pediatric Department, Niigata Prefectural Shibata Hospital, Shibata, Niigata, Japan
| | - Tokushi Nakano
- Pediatric Department, Nakano Children’s Clinic, Shibata, Niigata, Japan
| | - Shoji Sudo
- Pediatric Department, Sudo Pediatric Clinic, Shibata, Niigata, Japan
| | | | - Shuko Tokuriki
- Pediatric Department, Twin Smile Clinic, Shibata, Niigata, Japan
| | - Tsutomu Tamura
- Department of Virology, Niigata Prefectural Institute of Public Health and Environmental Sciences, Niigata, Japan
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Huda M, Ali T, Hasnani FB, Sayani S, Zaidi S. Predictors of Uptake of Rotavirus Vaccination Amongst Disadvantaged Communities in Pakistan. Glob Pediatr Health 2024; 11:2333794X241235746. [PMID: 38465209 PMCID: PMC10924542 DOI: 10.1177/2333794x241235746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 01/16/2024] [Accepted: 02/12/2024] [Indexed: 03/12/2024] Open
Abstract
Introduction. Pakistan has the highest childhood mortality associated with diarrheal diseases. The objective of this study is to identify underlying factors contributing to lack of knowledge among mothers regarding vaccine's efficacy in the prevention of diarrhea. Methodology. Secondary data was analyzed from a cross-sectional household survey in Northern Pakistan of eligible households having under-2-year children. Univariate and multivariate logistic regression analyses were carried out. Results. Only 30% of the mothers had knowledge regarding diarrhea prevention by vaccine. The main factors found significantly correlated with this knowledge were mother's education, distance of households from EPI centers, immunization status of children, counseling regarding clean drinking water and hygiene, provision of ORS, and antenatal care services by LHWs. Conclusion. Women's literacy, access to care and LHW services are important for improving awareness and acceptance of vaccines for vaccine preventable diseases including diarrhea. Policy makers need to focus on improved monitoring and reprioritization of undermined services by LHWs.
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Xia M, Huang P, Vago F, Kawagishi T, Ding S, Greenberg HB, Jiang W, Tan M. A Viral Protein 4-Based Trivalent Nanoparticle Vaccine Elicited High and Broad Immune Responses and Protective Immunity against the Predominant Rotaviruses. ACS Nano 2024; 18:6673-6689. [PMID: 38353701 DOI: 10.1021/acsnano.4c00544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
The current live rotavirus (RV) vaccines show reduced effectiveness in developing countries, calling for vaccine strategies with improved efficacy and safety. We generated pseudovirus nanoparticles (PVNPs) that display multiple ectodomains of RV viral protein 4 (VP4), named S-VP4e, as a nonreplicating RV vaccine candidate. The RV spike protein VP4s that bind host receptors and facilitate viral entry are excellent targets for vaccination. In this study, we developed scalable methods to produce three S-VP4e PVNPs, each displaying the VP4e antigens from one of the three predominant P[8], P[4], and P[6] human RVs (HRVs). These PVNPs were recognized by selected neutralizing VP4-specific monoclonal antibodies, bound glycan receptors, attached to permissive HT-29 cells, and underwent cleavage by trypsin between VP8* and VP5*. 3D PVNP models were constructed to understand their structural features. A trivalent PVNP vaccine containing the three S-VP4e PVNPs elicited high and well-balanced VP4e-specific antibody titers in mice directed against the three predominant HRV P types. The resulting antisera neutralized the three HRV prototypes at high titers; greater than 4-fold higher than the neutralizing responses induced by a trivalent vaccine consisting of the S60-VP8* PVNPs. Finally, the trivalent S-VP4e PVNP vaccine provided 90-100% protection against diarrhea caused by HRV challenge. Our data supports the trivalent S-VP4e PVNPs as a promising nonreplicating HRV vaccine candidate for parenteral delivery to circumvent the suboptimal immunization issues of all present live HRV vaccines. The established PVNP-permissive cell and PVNP-glycan binding assays will be instrumental for further investigating HRV-host cell interactions and neutralizing effects of VP4-specific antibodies and antivirals.
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Affiliation(s)
- Ming Xia
- Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, United States
| | - Pengwei Huang
- Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, United States
| | - Frank Vago
- Department of Biological Sciences, Purdue University, West Lafayette, Indiana 47907, United States
| | - Takahiro Kawagishi
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, Missouri 63110, United States
| | - Siyuan Ding
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, Missouri 63110, United States
| | - Harry B Greenberg
- Departments of Medicine and Microbiology and Immunology Emeritus, Stanford University School of Medicine, Stanford, California 94305, United States
| | - Wen Jiang
- Department of Biological Sciences, Purdue University, West Lafayette, Indiana 47907, United States
| | - Ming Tan
- Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio 45229, United States
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Tate JE, Mwenda JM, Keita AM, Tapsoba TW, Ngendahayo E, Kouamé BD, Samateh AL, Aliabadi N, Sissoko S, Traore Y, Bayisenga J, Sounkere-Soro M, Jagne S, Burke RM, Onwuchekwa U, Ouattara M, Bikoroti JB, N'Zue K, Leshem E, Coulibaly O, Ouedraogo I, Uwimana J, Sow S, Parashar UD. Evaluation of Intussusception Following Pentavalent Rotavirus Vaccine (RotaTeq) Administration in 5 African Countries. Clin Infect Dis 2024; 78:210-216. [PMID: 37596934 DOI: 10.1093/cid/ciad492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/07/2023] [Accepted: 08/16/2023] [Indexed: 08/21/2023] Open
Abstract
BACKGROUND A low-level risk of intussusception following rotavirus vaccination has been observed in some settings and may vary by vaccine type. We examined the association between RotaTeq vaccination and intussusception in low-income settings in a pooled analysis from 5 African countries that introduced RotaTeq into their national immunization program. METHODS Active surveillance was conducted at 20 hospitals to identify intussusception cases. A standard case report form was completed for each enrolled child, and vaccination status was determined by review of the child's vaccination card. The pseudo-likelihood adaptation of self-controlled case-series method was used to assess the association between RotaTeq administration and intussusception in the 1-7, 8-21, and 1-21 day periods after each vaccine dose in infants aged 28-245 days. RESULTS Data from 318 infants with confirmed rotavirus vaccination status were analyzed. No clustering of cases occurred in any of the risk windows after any of the vaccine doses. Compared with the background risk of naturally occurring intussusception, no increased risk was observed after dose 1 in the 1-7 day (relative incidence = 2.71; 95% confidence interval [CI] = 0.47-8.03) or the 8-21 day window (relative incidence = 0.77; 95%CI = 0.0-2.69). Similarly, no increased risk of intussusception was observed in any risk window after dose 2 or 3. CONCLUSIONS RotaTeq vaccination was not associated with increased risk of intussusception in this analysis from 5 African countries. This finding mirrors results from similar analyses with other rotavirus vaccines in low-income settings and highlights the need for vaccine-specific and setting-specific risk monitoring.
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Affiliation(s)
- Jacqueline E Tate
- US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jason M Mwenda
- World Health Organization Regional Office for Africa, Brazzaville, Congo
| | | | | | | | | | | | - Negar Aliabadi
- US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Yacouba Traore
- Centre Hospitalier Universitaire Sourou SANOU de Bobo Dioulasso, Bobo Dioulasso, Burkina Faso
| | | | | | - Sheriffo Jagne
- National Public Health Reference Laboratory, Ministry of Health, Banjul, The Gambia
| | - Rachel M Burke
- US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Ma Ouattara
- World Health Organization Country Office, Ouagadougou, Burkina Faso
| | | | - Kofi N'Zue
- World Health Organization Country Office, Abidjan, Cote d'Ivoire
| | - Eyal Leshem
- US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Oumar Coulibaly
- Centre Hospitalier Universitaire Gabriel Touré, Bamako, Mali
| | - Issa Ouedraogo
- Ministry of Health, Expanded Program on Immunizations, Ouagadougou, Burkina Faso
| | | | - Samba Sow
- Center for Vaccine Development, Bamako, Mali
| | - Umesh D Parashar
- US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Carossino M, Vissani MA, Barrandeguy ME, Balasuriya UBR, Parreño V. Equine Rotavirus A under the One Health Lens: Potential Impacts on Public Health. Viruses 2024; 16:130. [PMID: 38257830 PMCID: PMC10819593 DOI: 10.3390/v16010130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 12/29/2023] [Accepted: 01/12/2024] [Indexed: 01/24/2024] Open
Abstract
Group A rotaviruses are a well-known cause of viral gastroenteritis in infants and children, as well as in many mammalian species and birds, affecting them at a young age. This group of viruses has a double-stranded, segmented RNA genome with high genetic diversity linked to point mutations, recombination, and, importantly, reassortment. While initial molecular investigations undertaken in the 1900s suggested host range restriction among group A rotaviruses based on the fact that different gene segments were distributed among different animal species, recent molecular surveillance and genome constellation genotyping studies conducted by the Rotavirus Classification Working Group (RCWG) have shown that animal rotaviruses serve as a source of diversification of human rotavirus A, highlighting their zoonotic potential. Rotaviruses occurring in various animal species have been linked with contributing genetic material to human rotaviruses, including horses, with the most recent identification of equine-like G3 rotavirus A infecting children. The goal of this article is to review relevant information related to rotavirus structure/genomic organization, epidemiology (with a focus on human and equine rotavirus A), evolution, inter-species transmission, and the potential zoonotic role of equine and other animal rotaviruses. Diagnostics, surveillance and the current status of human and livestock vaccines against RVA are also reviewed.
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Affiliation(s)
- Mariano Carossino
- Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA;
- Louisiana Animal Disease Diagnostic Laboratory, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA
| | - Maria Aldana Vissani
- Escuela de Veterinaria, Facultad de Ciencias Agrarias y Veterinarias, Universidad del Salvador, Pilar, Buenos Aires B1630AHU, Argentina; (M.A.V.); (M.E.B.)
- Instituto de Virología, CICVyA, Instituto Nacional de Tecnología Agropecuaria (INTA), Buenos Aires B1686LQF, Argentina;
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires C1033AAJ, Argentina
| | - Maria E. Barrandeguy
- Escuela de Veterinaria, Facultad de Ciencias Agrarias y Veterinarias, Universidad del Salvador, Pilar, Buenos Aires B1630AHU, Argentina; (M.A.V.); (M.E.B.)
- Instituto de Virología, CICVyA, Instituto Nacional de Tecnología Agropecuaria (INTA), Buenos Aires B1686LQF, Argentina;
| | - Udeni B. R. Balasuriya
- Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA;
- Louisiana Animal Disease Diagnostic Laboratory, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA
| | - Viviana Parreño
- Instituto de Virología, CICVyA, Instituto Nacional de Tecnología Agropecuaria (INTA), Buenos Aires B1686LQF, Argentina;
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires C1033AAJ, Argentina
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6
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Britoh Mlan A, Burke RM, Koné H, Boni-Cisse C, N'Guessan R, Zaba F, Aka LN, N'Zue K, Adom SK, Kouadio SK, Bhérat Kouadio A, Meité S, Koffi S, Faye-Kette H, Shaba K, Ntsama B, Biey J, Aliabadi N, Mwenda JM, Parashar UD, Tate JE. Impact of rotavirus vaccine introduction in Abidjan, Côte d'Ivoire. Hum Vaccin Immunother 2023; 19:2156231. [PMID: 36719054 PMCID: PMC9980462 DOI: 10.1080/21645515.2022.2156231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Côte d'Ivoire introduced rotavirus vaccine in March 2017. Rotavirus surveillance is conducted at Centre Hospitalier Universitaire de Yopougon in Abidjan, the capital city. Children <5 years of age are enrolled in rotavirus surveillance if admitted to the hospital with acute gastroenteritis. We used sentinel surveillance data from 2014 through mid-2019 to compare trends in rotavirus pediatric gastroenteritis hospitalizations before and after rotavirus vaccine introduction. We used Poisson regression to analyze changes in rotavirus prevalence, adjusting for calendar month and accounting for total monthly admissions; January 2014 - December 2016 was considered "pre-vaccine," and January 2017 - June 2019 was considered "post-vaccine." Age distribution and severity were compared between periods using the Mann-Whitney U test. Rotavirus-positive admissions declined 51% (95% CI: 28%-67%), from 31.5% pre-vaccine to 14.9% afterward. The median age of rotavirus-positive children increased from 7 months (interquartile range [IQR]: 5-11) in the pre-vaccine period to 11 months (IQR: 7-18, p = .005) in the post-vaccine period. The median severity score decreased from 11 to 9 (p = .008) among all children, and from 12 pre- to 10.5 post-vaccine (p = .35) among rotavirus-positive children. Our findings suggest that rotavirus vaccine introduction contributed to reduced rotavirus hospitalization in Abidjan and possibly more broadly.
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Affiliation(s)
- Alice Britoh Mlan
- Centre Hospitalier Universitaire de Yopougon, Abidjan, Côte d'Ivoire
| | - Rachel M Burke
- Viral Gastroenteritis Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Hamidou Koné
- Direction de Programme Elargi de Vaccination, Abidjan, Côte d'Ivoire
| | | | - Rebecca N'Guessan
- Centre Hospitalier Universitaire de Yopougon, Abidjan, Côte d'Ivoire
| | - Flore Zaba
- Centre Hospitalier Universitaire de Yopougon, Abidjan, Côte d'Ivoire
| | - Lepri Nicaise Aka
- Direction de Programme Elargi de Vaccination, Abidjan, Côte d'Ivoire
| | - Kofi N'Zue
- Country Office for Côte d'Ivoire, World Health Organization, Abidjan, Côte d'Ivoire
| | - San Koffi Adom
- Country Office for Côte d'Ivoire, World Health Organization, Abidjan, Côte d'Ivoire
| | - Sié Kabran Kouadio
- Country Office for Côte d'Ivoire, World Health Organization, Abidjan, Côte d'Ivoire
| | | | - Syndou Meité
- Centre Hospitalier Universitaire de Yopougon, Abidjan, Côte d'Ivoire.,Institut Pasteur, Abidjan, Côte d'Ivoire
| | | | | | - Keith Shaba
- World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | - Bernard Ntsama
- World Health Organization Regional Office for Africa, Inter-Support Team for West Africa, Ouagadougou, Burkina Faso
| | - Joseph Biey
- World Health Organization Regional Office for Africa, Inter-Support Team for West Africa, Ouagadougou, Burkina Faso
| | - Negar Aliabadi
- Viral Gastroenteritis Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jason M Mwenda
- World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | - Umesh D Parashar
- Viral Gastroenteritis Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jacqueline E Tate
- Viral Gastroenteritis Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Arau B, Dietl B, Sudrià-Lopez E, Ribes J, Pareja L, Marquès T, Garcia-Puig R, Pujalte F, Martin-Cardona A, Fernández-Bañares F, Mariné M, Farré C, Esteve M. A Population-Based Cross-Sectional Study of Paediatric Coeliac Disease in Catalonia Showed a Downward Trend in Prevalence Compared to the Previous Decade. Nutrients 2023; 15:5100. [PMID: 38140358 PMCID: PMC10745851 DOI: 10.3390/nu15245100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
(1) Background: Previous studies showed an increased prevalence and incidence of coeliac disease (CD) over time. The objective is to ascertain whether the CD prevalence in Catalonia (a region of Southern Europe) among children aged 1-5 is as high as previously found in 2004-2009; (2) Methods: From 2013 to 2019, 3659 subjects aged 1-5 years were recruited following the previously used methodology. Factors with a potential impact on CD prevalence were investigated; (3) Results: In 2013-2019, 43/3659 subjects had positive serology, giving a standardised seroprevalence of 12.55/1000 (95% CI: 8.92; 17.40), compared to 23.62 (13.21; 39.40) in 2004-2007. The biopsy-proven crude prevalence was 7.92/1000 (95% CI: 5.50; 11.30), and the crude prevalence based on ESPGHAN criteria was 8.74/1000 (95% CI: 6.20-12.30). In contrast to 2004-2009, we did not find differences in the seroprevalence rates between 1 and 2 years vs. 3 and 4 years of age (age percentage of change -7.0 (-29.5; 22.8) vs. -45.3 (-67.5; -8.0)). Rotavirus vaccination was the most remarkable potential protective factor (48% vs. 9% in 2004-2009; p < 0.0001), but not the time of gluten introduction. (4) Conclusion: The present study did not confirm a worldwide CD prevalence increase and emphasizes the need to perform prevalence studies over time using the same methodology in the same geographical areas.
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Affiliation(s)
- Beatriz Arau
- Digestive Diseases Department, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Pl. del Doctor Robert 5, 08221 Terrassa, Spain; (B.A.); (E.S.-L.); (A.M.-C.); (F.F.-B.)
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Av. Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain;
| | - Beatriz Dietl
- Internal Medicine and Infectious Diseases Department, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Pl. del Doctor Robert 5, 08221 Terrassa, Spain;
| | - Emma Sudrià-Lopez
- Digestive Diseases Department, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Pl. del Doctor Robert 5, 08221 Terrassa, Spain; (B.A.); (E.S.-L.); (A.M.-C.); (F.F.-B.)
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Av. Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain;
| | - Josefa Ribes
- ICO-ICS Multicenter Hospital Tumor Registry Service, Catalan Institute of Oncology, Gran via de l’Hospitalet 199-203, 08908 L’Hospitalet de Llobregat, Spain; (J.R.); (L.P.)
- Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Bellvitge Campus, Carrer de la Feixa Llarga, s/n, 08907 L’Hospitalet de Llobregat, Spain
- Cancer Epidemiology, Bellvitge Biomedical Research Institute (IDIBELL), Gran via de l’Hospitalet 199, 08908 L’Hospitalet de Llobregat, Spain
| | - Laura Pareja
- ICO-ICS Multicenter Hospital Tumor Registry Service, Catalan Institute of Oncology, Gran via de l’Hospitalet 199-203, 08908 L’Hospitalet de Llobregat, Spain; (J.R.); (L.P.)
- Cancer Epidemiology, Bellvitge Biomedical Research Institute (IDIBELL), Gran via de l’Hospitalet 199, 08908 L’Hospitalet de Llobregat, Spain
- Nursing Department of Public Health, Mental Health and Maternal and Child, School of Medicine, Universitat de Barcelona, Bellvitge Campus, Carrer de la Feixa Llarga, s/n, 08907 L’Hospitalet de Llobregat, Spain
| | - Teresa Marquès
- Department of Biochemistry, Hospital de Sant Joan de Déu, Passeig Sant Joan de Déu 2, 08950 Esplugues de Llobregat, Spain; (T.M.); (C.F.)
| | - Roger Garcia-Puig
- Department of Paediatrics, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Pl. del Doctor Robert 5, 08221 Terrassa, Spain;
| | - Francisco Pujalte
- Catlab, Department of Immunology, Vial St Jordi s/n, 08232 Viladecavalls, Spain;
| | - Albert Martin-Cardona
- Digestive Diseases Department, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Pl. del Doctor Robert 5, 08221 Terrassa, Spain; (B.A.); (E.S.-L.); (A.M.-C.); (F.F.-B.)
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Av. Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain;
| | - Fernando Fernández-Bañares
- Digestive Diseases Department, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Pl. del Doctor Robert 5, 08221 Terrassa, Spain; (B.A.); (E.S.-L.); (A.M.-C.); (F.F.-B.)
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Av. Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain;
| | - Meritxell Mariné
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Av. Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain;
- Internal Medicine and Infectious Diseases Department, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Pl. del Doctor Robert 5, 08221 Terrassa, Spain;
| | - Carme Farré
- Department of Biochemistry, Hospital de Sant Joan de Déu, Passeig Sant Joan de Déu 2, 08950 Esplugues de Llobregat, Spain; (T.M.); (C.F.)
| | - Maria Esteve
- Digestive Diseases Department, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Pl. del Doctor Robert 5, 08221 Terrassa, Spain; (B.A.); (E.S.-L.); (A.M.-C.); (F.F.-B.)
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Av. Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain;
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Liu Z, Li N, Liu G, Xu L, Dong Y, Meng R, Yang Y, Zhan S. No increased risk of intussusception after pentavalent rotavirus vaccination in China: a retrospective birth cohort using electronic health records of Ningbo city. Emerg Microbes Infect 2023; 12:2270062. [PMID: 37815175 PMCID: PMC10606783 DOI: 10.1080/22221751.2023.2270062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/05/2023] [Indexed: 10/11/2023]
Abstract
Some post-licensure studies have shown a potential increased risk of intussusception following vaccination with rotavirus vaccines. This is the first study that aimed to assess the incidence and risk of intussusception within 90 days after vaccination with RotaTeq in Chinese infants. A population-based birth cohort from 27th November 2018 to 30th June 2021 included all newborns in Ningbo city. The records of intussusception were identified through the ICD-10 code K56.1 or Chinese keywords "Chang Tao" from all hospital discharge records. Each episode was confirmed in line with the Brighton criteria, and only Brighton level 1 cases were included. The association of RotaTeq vaccination and intussusception was evaluated using the Poisson regression. A total of 108,405 eligible subjects from birth cohort were eligible, with 52.30% males. Among them, 26, 847 (24.77%) infants received at least one dose of RotaTeq, and 95.52% of them were fully vaccinated, with 76, 934 doses in total. After adjudication, none of the cases occurred post first, or second dose, the cumulative number of cases that occurred 1-7, 1-14, 1-21, 1-42, and 1-90 days post third dose was 0, 1, 1, 3, and 7, respectively. Adjusting for age, sex, birth year, birth season and location, the incidence rate ratio of intussusception after RotaTeq vaccination was 0.90 (90% two-sided CI: 0.46, 1.75). Increasing age and male gender were associated with higher risk of intussusception. In summary, no increased risk of IS was observed following 3 months of RotaTeq vaccination in this study.
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Affiliation(s)
- Zhike Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, People’s Republic of China
- Key Laboratory of Epidemiology of Major Diseases, Peking University, Ministry of Education, Beijing, People’s Republic of China
| | - Ning Li
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo, People’s Republic of China
| | - Guangxu Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, People’s Republic of China
| | - Lu Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, People’s Republic of China
- Key Laboratory of Epidemiology of Major Diseases, Peking University, Ministry of Education, Beijing, People’s Republic of China
| | - Ying Dong
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo, People’s Republic of China
| | - Ruogu Meng
- Institute for Artificial Intelligence, Peking University, Beijing, People’s Republic of China
| | - Yu Yang
- Institute for Artificial Intelligence, Peking University, Beijing, People’s Republic of China
| | - Siyan Zhan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, People’s Republic of China
- Key Laboratory of Epidemiology of Major Diseases, Peking University, Ministry of Education, Beijing, People’s Republic of China
- Institute for Artificial Intelligence, Peking University, Beijing, People’s Republic of China
- Peking University Third Hospital, Research Center of Clinical Epidemiology, Beijing, People’s Republic of China
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9
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Mai CTN, Ly LTK, Doan YH, Oka T, Mai LTP, Quyet NT, Mai TNP, Thiem VD, Anh LT, Van Sanh L, Hien ND, Anh DD, Parashar UD, Tate JE, Van Trang N. Prevalence and Characterization of Gastroenteritis Viruses among Hospitalized Children during a Pilot Rotavirus Vaccine Introduction in Vietnam. Viruses 2023; 15:2164. [PMID: 38005842 PMCID: PMC10675811 DOI: 10.3390/v15112164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/16/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023] Open
Abstract
Rotavirus (RV), norovirus (NoV), sapovirus (SaV), and human astrovirus (HAstV) are the most common viral causes of gastroenteritis in children worldwide. From 2016 to 2021, we conducted a cross-sectional descriptive study to determine the prevalence of these viruses in hospitalized children under five years old in Nam Dinh and Thua Thien Hue provinces in Vietnam during the pilot introduction of the RV vaccine, Rotavin-M1 (POLYVAC, Hanoi, Vietnam). We randomly selected 2317/6718 (34%) acute diarrheal samples from children <5 years of age enrolled at seven sentinel hospitals from December 2016 to May 2021; this period included one year surveillance pre-vaccination from December 2016 to November 2017. An ELISA kit (Premier Rotaclone®, Meridian Bioscience, Inc., Cincinnati, OH, USA) was used to detect RV, and two multiplex real-time RT-PCR assays were used for the detection of NoV, SaV and HAstV. The prevalence of RV (single infection) was reduced from 41.6% to 22.7% (p < 0.0001) between pre- and post-vaccination periods, while the single NoV infection prevalence more than doubled from 8.8% to 21.8% (p < 0.0001). The SaV and HAstV prevalences slightly increased from 1.9% to 3.4% (p = 0.03) and 2.1% to 3.3% (p = 0.09), respectively, during the same period. Viral co-infections decreased from 7.2% to 6.0% (p = 0.24), mainly due to a reduction in RV infection. Among the genotypeable samples, NoV GII.4, SaV GI.1, and HAstV-1 were the dominant types, representing 57.3%, 32.1%, and 55.0% among the individual viral groups, respectively. As the prevalence of RV decreases following the national RV vaccine introduction in Vietnam, other viral pathogens account for a larger proportion of the remaining diarrhea burden and require continuing close monitoring.
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Affiliation(s)
- Chu Thi Ngoc Mai
- National Institute of Hygiene and Epidemiology, Hanoi 100000, Vietnam; (C.T.N.M.); (L.T.K.L.); (T.N.P.M.); (V.D.T.)
| | - Le Thi Khanh Ly
- National Institute of Hygiene and Epidemiology, Hanoi 100000, Vietnam; (C.T.N.M.); (L.T.K.L.); (T.N.P.M.); (V.D.T.)
| | - Yen Hai Doan
- Center for Emergency Preparedness and Response, National Institute of Infectious Diseases, Tokyo 208-0011, Japan
| | - Tomoichiro Oka
- Department of Virology II, National Institute of Infectious Diseases, Tokyo 208-0011, Japan
| | - Le Thi Phuong Mai
- National Institute of Hygiene and Epidemiology, Hanoi 100000, Vietnam; (C.T.N.M.); (L.T.K.L.); (T.N.P.M.); (V.D.T.)
| | - Nguyen Tu Quyet
- National Institute of Hygiene and Epidemiology, Hanoi 100000, Vietnam; (C.T.N.M.); (L.T.K.L.); (T.N.P.M.); (V.D.T.)
| | - Tran Ngoc Phuong Mai
- National Institute of Hygiene and Epidemiology, Hanoi 100000, Vietnam; (C.T.N.M.); (L.T.K.L.); (T.N.P.M.); (V.D.T.)
| | - Vu Dinh Thiem
- National Institute of Hygiene and Epidemiology, Hanoi 100000, Vietnam; (C.T.N.M.); (L.T.K.L.); (T.N.P.M.); (V.D.T.)
| | - Lai Tuan Anh
- Nam Dinh Center for Disease Control, Nam Dinh 420000, Vietnam
| | - Le Van Sanh
- TT Hue Center for Disease Control, Hue, Thua Thien Hue 530000, Vietnam
| | - Nguyen Dang Hien
- Center for Research and Production of Vaccines and Biologicals, Hanoi 100000, Vietnam
| | - Dang Duc Anh
- National Institute of Hygiene and Epidemiology, Hanoi 100000, Vietnam; (C.T.N.M.); (L.T.K.L.); (T.N.P.M.); (V.D.T.)
| | | | | | - Nguyen Van Trang
- National Institute of Hygiene and Epidemiology, Hanoi 100000, Vietnam; (C.T.N.M.); (L.T.K.L.); (T.N.P.M.); (V.D.T.)
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10
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Fellows T, Page N, Fix A, Flores J, Cryz S, McNeal M, Iturriza-Gomara M, Groome MJ. Association between Immunogenicity of a Monovalent Parenteral P2-VP8 Subunit Rotavirus Vaccine and Fecal Shedding of Rotavirus following Rotarix Challenge during a Randomized, Double-Blind, Placebo-Controlled Trial. Viruses 2023; 15:1809. [PMID: 37766217 PMCID: PMC10536230 DOI: 10.3390/v15091809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/18/2023] [Accepted: 08/23/2023] [Indexed: 09/29/2023] Open
Abstract
A correlate of protection for rotavirus (RV) has not been consistently identified. Shedding of RV following an oral rotavirus vaccine (ORV) challenge has been investigated as a potential model to assess protection of parenteral RV vaccines. We previously showed that shedding of a challenge ORV dose was significantly reduced among recipients of a parenteral monovalent RV subunit vaccine (P2-VP8-P[8]) compared to placebo recipients. This secondary data analysis assessed the association between fecal shedding of RV, as determined by ELISA one week after receipt of a Rotarix challenge dose at 18 weeks of age, and serum RV-specific antibody responses, one and six months after vaccination with the third dose of the P2-VP8-P[8] vaccine or placebo. We did not find any association between serum RV-specific immune responses measured one month post-P2-VP8-P[8] vaccination and fecal shedding of RV post-challenge. At nine months of age, six months after the third P2-VP8-P[8] or placebo injection and having received three doses of Rotarix, infants shedding RV demonstrated higher immune responses than non-shedders, showing that RV shedding is reflective of vaccine response following ORV. Further evaluation is needed in a larger sample before fecal shedding of an ORV challenge can be used as a measure of field efficacy in RV vaccine trials.
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Affiliation(s)
- Tamika Fellows
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2001, South Africa;
| | - Nicola Page
- National Institute for Communicable Diseases, A Division of the National Health Laboratory Service, Sandringham 2192, South Africa;
- Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria 0028, South Africa
| | - Alan Fix
- PATH, Seattle, WA 98121, USA (S.C.)
| | | | | | - Monica McNeal
- Department of Pediatrics, University of Cincinnati Medical School, Cincinnati, OH 45229, USA
- Division of Infectious Diseases, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | | | - Michelle J. Groome
- South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2001, South Africa
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11
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Wang G, Zhang K, Zhang R, Kong X, Guo C. Impact of vaccination with different types of rotavirus vaccines on the incidence of intussusception: a randomized controlled meta-analysis. Front Pediatr 2023; 11:1239423. [PMID: 37583623 PMCID: PMC10424850 DOI: 10.3389/fped.2023.1239423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 07/20/2023] [Indexed: 08/17/2023] Open
Abstract
Background Intussusception is a prevalent pediatric issue causing acute abdominal pain, with potential links to rotavirus vaccines. The variety of these vaccines has grown in recent years. This meta-analysis study aims to evaluate the impact of various rotavirus vaccines on intussusception incidence. Methods We executed a thorough search across databases like PubMed, Cochrane Library, Embase, and Web of Science, leading to the selection of 15 credible randomized controlled trials (RCTs) that encompass various types of rotavirus vaccines. From each study, we extracted essential details such as vaccine types and intussusception occurrences. We assessed the risk of bias using the Cochrane Collaboration's tool, conducted statistical analysis with R (version 4.2.3), determined relative risk (RR) using a random effects model, and performed a subgroup analysis for vaccines of differing brands and types. Results We included 15 randomized controlled studies from various countries. While intussusception incidence differed between vaccinated and control groups, this difference was not statistically significant. The overall risk ratio (RR), calculated using a random effects model, was 0.81, with a 95% confidence interval of [0.53, 1.23]. This crossing 1 shows that vaccination didn't notably change disease risk. Additionally, the 0% group heterogeneity suggests consistency across studies, strengthening our conclusions. Subgroup analysis for different vaccine brands and types (RV1 (Rotarix, Rotavac, RV3-BB), RV3 (LLR3), RV5 (RotasiiL, RotaTeq), and RV6) showed no significant variation in intussusception incidence. Despite variations in RR among subgroups, these differences were not statistically significant (P > 0.05). Conclusions Our study indicates that rotavirus vaccination does not significantly increase the incidence of intussusception. Despite varying impacts across different vaccine brands and types, these variations are insignificant. Given the substantial benefits outweighing the risks, promoting the use of newly developed rotavirus vaccines remains highly valuable. Systematic Review Registration www.crd.york.ac.uk/prospero/, Identifier CRD42023425279.
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Affiliation(s)
- Guoyong Wang
- Department of Pediatrics, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Pediatric General Surgery, Children's Hospital, Chongqing Medical University, Chongqing, China
- National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics,Chongqing Medical University, Chongqing, China
| | - Kaijun Zhang
- Department of Pediatrics, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Pediatric General Surgery, Children's Hospital, Chongqing Medical University, Chongqing, China
- National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics,Chongqing Medical University, Chongqing, China
| | - Rensen Zhang
- Department of Pediatrics, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Pediatrics, Chongqing Health Center for Women and Children, Chongqing, China
| | - Xiangru Kong
- Department of Pediatric General Surgery, Children's Hospital, Chongqing Medical University, Chongqing, China
- National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics,Chongqing Medical University, Chongqing, China
| | - Chunbao Guo
- Department of Pediatrics, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics,Chongqing Medical University, Chongqing, China
- Department of Pediatrics, Chongqing Health Center for Women and Children, Chongqing, China
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12
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Sifuna P, Shaw AV, Lucas T, Ogutu B, Otieno W, Larsen DA. Deployment of Rotavirus Vaccine in Western Kenya Coincides with a Reduction in All-Cause Child Mortality: A Retrospective Cohort Study. Vaccines (Basel) 2023; 11:1299. [PMID: 37631867 PMCID: PMC10458991 DOI: 10.3390/vaccines11081299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 08/27/2023] Open
Abstract
Rotavirus is an important cause of fatal pediatric diarrhea worldwide. Many national immunization programs began adding rotavirus vaccine following a 2009 World Health Organization recommendation. Kenya added rotavirus vaccine to their immunization program at the end of 2014. From a cohort of 38,463 children in the Kisumu health and demographic surveillance site in western Kenya, we assessed how the implementation of the rotavirus vaccine affected mortality in children under 3 years of age. Following its introduction in late 2014, the span of rotavirus vaccine coverage for children increased to 75% by 2017. Receiving the rotavirus vaccine was associated with a 44% reduction in all-cause child mortality (95% confidence interval = 28-68%, p < 0.0001), but not diarrhea-specific mortality (p = 0.401). All-cause child mortality declined 2% per month following the implementation of the rotavirus vaccine (p = 0.002) among both vaccinated and unvaccinated children, but diarrhea-specific mortality was not associated with the implementation of the rotavirus vaccine independent of individual vaccine status (p = 0.125). The incidence of acute diarrhea decreased over the study period, and the introduction of the rotavirus vaccine was not associated with population-wide trends (p = 0.452). The receipt of the rotavirus vaccine was associated with a 34% reduction in the incidence of diarrhea (95% confidence interval = 24-43% reduction). These results suggest that rotavirus vaccine may have had an impact on all-cause child mortality. The analyses of diarrhea-specific mortality were limited by relatively few deaths (n = 57), as others have found a strong reduction in diarrhea-specific mortality. Selection bias may have played a part in these results-children receiving rotavirus vaccine were more likely to be fully immunized than children not receiving the rotavirus vaccine.
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Affiliation(s)
- Peter Sifuna
- Kenya Medical Research Institute (KEMRI), Kisumu 40100, Kenya; (P.S.); (T.L.); (B.O.); (W.O.)
- US Army Medical Research Directorate–Africa (USAMRD-A), Kisumu 00200, Kenya
| | - Andrea V. Shaw
- Institute for Global Health and Translational Science, SUNY Upstate Medical University, Syracuse, NY 13210, USA;
| | - Tina Lucas
- Kenya Medical Research Institute (KEMRI), Kisumu 40100, Kenya; (P.S.); (T.L.); (B.O.); (W.O.)
- US Army Medical Research Directorate–Africa (USAMRD-A), Kisumu 00200, Kenya
| | - Bernards Ogutu
- Kenya Medical Research Institute (KEMRI), Kisumu 40100, Kenya; (P.S.); (T.L.); (B.O.); (W.O.)
- US Army Medical Research Directorate–Africa (USAMRD-A), Kisumu 00200, Kenya
| | - Walter Otieno
- Kenya Medical Research Institute (KEMRI), Kisumu 40100, Kenya; (P.S.); (T.L.); (B.O.); (W.O.)
- US Army Medical Research Directorate–Africa (USAMRD-A), Kisumu 00200, Kenya
| | - David A. Larsen
- Department of Public Health, Syracuse University, Syracuse, NY 13244, USA
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13
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Gomez J, Velázquez FR, Guzman-Holst A, Cervantes Apolinar MY, Van Bellinghen LA, Van Vlaenderen I, van Oorschot D. Cost-effectiveness analysis measuring the total costs against the health benefits of three different rotavirus vaccines for Mexico. Hum Vaccin Immunother 2023:2219189. [PMID: 37339232 DOI: 10.1080/21645515.2023.2219189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/05/2023] [Accepted: 05/23/2023] [Indexed: 06/22/2023] Open
Abstract
Rotavirus (RV) infection causes acute rotavirus gastroenteritis (RVGE) in infants. Safe and effective RV vaccines are available, of which Mexico has included one in its national immunization program (NIP) since 2007. Health outcome gains, expressed in quality-adjusted life years (QALYs), and cost improvements are important additional factors for the selection of a NIP vaccine. These two factors were analyzed here for Mexico over one year implementing three RV vaccines: 2-dose Rotarix (HRV), versus 3-dose RotaTeq (HBRV), and 3-dose Rotasiil (BRV-PV), presented in a 1-dose or 2-dose vial). HRV would annually result in discounted QALY gains of 263 extra years compared with the other vaccines by averting an extra 24,022 homecare cases, 10779 medical visits, 392 hospitalizations, and 12 deaths. From a payer's perspective and compared with HRV, BRV-PV 2-dose vial and BRV-PV 1-dose vial would annually result in $13.5 million and $4.6 million net savings, respectively, while HBRV would result in $3.4 million extra costs. The societal perspective may also show savings compared with HRV for BRV-PV 2-dose vial of $4.9 million, while BRV-PV 1-dose vial and HBRV may show extra costs of $4.0 million and $12.1 million respectively. HRV and HBRV were both approved in Mexico, with HRV requiring less investment than HBRV with higher QALY gains and cost savings. The HRV vaccine produced those higher health gains due to its earlier protection and greater coverage achieved after its schedule completion with two doses only, providing full protection at four months of age instead of longer periods for the other vaccines.
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14
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Isonne C, Petrone D, Del Manso M, Iera J, Caramia A, Bandini L, Fadda G, Grossi A, Baccolini V, Costantino C, Pezzotti P, Siddu A, D'Ancona F. The Impact of Rotavirus Vaccination on Discharges for Pediatric Gastroenteritis in Italy: An Eleven Year (2009-2019) Nationwide Analysis. Vaccines (Basel) 2023; 11:1037. [PMID: 37376427 DOI: 10.3390/vaccines11061037] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/11/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
In Italy, despite the documented positive effects of rotavirus (RV) vaccination on reducing the burden of RV disease, an updated national assessment of its impact on clinical outcomes is still lacking. This study aims to analyze the implementation of RV vaccination in Italy, evaluating its impact on discharges for acute pediatric gastroenteritis (AGE). A retrospective analysis, including hospital discharge records and data on vaccination coverage for children aged 0-71 months from 2009 to 2019, was conducted. We examined trends in hospital discharge standardized incidence before and after vaccine introduction using a negative binomial mixture model with fixed effects to evaluate the impact of universal vaccination. The percentage of vaccination coverage increased over the years, from <5% between 2009 and 2013 to 26% in 2017, reaching 70% in 2019. The standardized incidence of discharges decreased over the period from 16.6/100,000 inhabitants in 2009-2013 to 9.9/100,000 inhabitants in 2018-2019. In this phase, about 15% of the estimated hospital discharges were avoided compared with those estimated in the first phase. The implementation of RV vaccination reduced AGE incidence discharges in children aged 0-71 months. Further efforts are needed to continue monitoring the vaccination effect over time and to increase vaccination coverage.
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Affiliation(s)
- Claudia Isonne
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00162 Rome, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Daniele Petrone
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00162 Rome, Italy
- Department of Statistics, Sapienza University of Rome, 00185 Rome, Italy
| | - Martina Del Manso
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00162 Rome, Italy
| | - Jessica Iera
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
- Management and Health Laboratory, Institute of Management-Department EMbeDS, Sant'Anna School of Advanced Studies, 56127 Pisa, Italy
| | - Alessandra Caramia
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00162 Rome, Italy
- Policlinico Riuniti Foggia Hospital, Hygiene Unit, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
| | - Lorenzo Bandini
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00162 Rome, Italy
| | - Giulia Fadda
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00162 Rome, Italy
| | - Adriano Grossi
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00162 Rome, Italy
| | - Valentina Baccolini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Claudio Costantino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy
| | - Patrizio Pezzotti
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00162 Rome, Italy
| | - Andrea Siddu
- Ministry of Health, Directorate General Health Prevention, Communicable Diseases and International Prophylaxis, 00144 Rome, Italy
| | - Fortunato D'Ancona
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00162 Rome, Italy
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15
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Deichsel EL, Powell H, Troeger C, Hossain MJ, Sow SO, Omore R, Jasseh M, Onwuchekwa U, Obor D, Sanogo D, Jones JCM, Nasrin D, Tapia MD, Kotloff KL. Drivers of Decline in Diarrhea Mortality Between GEMS and VIDA Studies. Clin Infect Dis 2023; 76:S58-S65. [PMID: 37074431 PMCID: PMC10116520 DOI: 10.1093/cid/ciad015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Statistical modeling suggests that decreasing diarrhea-associated mortality rates in recent decades are largely attributed to improved case management, rotavirus vaccine, and economic development. METHODS We examined data collected in 2 multisite population-based diarrhea case-control studies, both conducted in The Gambia, Kenya, and Mali: the Global Enteric Multicenter Study (GEMS; 2008-2011) and Vaccine Impact on Diarrhea in Africa (VIDA; 2015-2018). Population-level diarrhea mortality and risk factor prevalence, estimated using these study data, were used to calculate the attribution of risk factors and interventions for diarrhea mortality using a counterfactual framework. We performed a decomposition of the effects of the changes in exposure to each risk factor between GEMS and VIDA on diarrhea mortality for each site. RESULTS Diarrhea mortality among children under 5 in our African sites decreased by 65.3% (95% confidence interval [CI]: -80.0%, -45.0%) from GEMS to VIDA. Kenya and Mali had large relative declines in diarrhea mortality between the 2 periods with 85.9% (95% CI: -95.1%, -71.5%) and 78.0% (95% CI: -96.0%, 36.3%) reductions, respectively. Among the risk factors considered, the largest declines in diarrhea mortality between the 2 study periods were attributed to reduction in childhood wasting (27.2%; 95% CI: -39.3%, -16.8%) and an increased rotavirus vaccine coverage (23.1%; 95% CI: -28.4%, -19.4%), zinc for diarrhea treatment (12.1%; 95% CI: -16.0%, -8.9%), and oral rehydration salts (ORS) for diarrhea treatment (10.2%). CONCLUSIONS The VIDA study sites demonstrated exceptional reduction in diarrhea mortality over the last decade. Site-specific differences highlight an opportunity for implementation science in collaboration with policymakers to improve the equitable coverage of these interventions globally.
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Affiliation(s)
- Emily L Deichsel
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Helen Powell
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Christopher Troeger
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - M Jahangir Hossain
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Samba O Sow
- Centre pour le Développement des Vaccins du Mali (CVD-Mali), Bamako, Mali
| | - Richard Omore
- Kenya Medical Research Institute, Center for Global Health Research (KEMRI-CGHR), Kisumu, Kenya
| | - Momodou Jasseh
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Uma Onwuchekwa
- Centre pour le Développement des Vaccins du Mali (CVD-Mali), Bamako, Mali
| | - David Obor
- Kenya Medical Research Institute, Center for Global Health Research (KEMRI-CGHR), Kisumu, Kenya
| | - Doh Sanogo
- Centre pour le Développement des Vaccins du Mali (CVD-Mali), Bamako, Mali
| | - Joquina Chiquita M Jones
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Dilruba Nasrin
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Milagritos D Tapia
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Karen L Kotloff
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
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16
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Olsson-Åkefeldt S, Rotzén Östlund M, Hammas B, Eriksson M, Bennet R. Reduction of rotavirus as a cause of nosocomial diarrhoea in northern Stockholm after introducing the rotavirus vaccine. Infect Dis (Lond) 2023; 55:175-180. [PMID: 36527430 DOI: 10.1080/23744235.2022.2153912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background: Vaccination against rotavirus was offered in Stockholm to children born on 1 March 2014 and onwards with 85% coverage after two years. We investigated changes in nosocomial diarrhoea 2010-2018 in children admitted to Astrid Lindgren Children's Hospital, Stockholm, Sweden. Methods: We retrospectively identified cases from diagnostic and virology department registers. Complications and chronic medical conditions were retrieved from the case records. Children <18 years of age who developed diarrhoea ≥48 h after admission for another diagnosis and had a faecal sample submitted to the virology department were included. Results: There were 474 episodes of nosocomial diarrhoea. Of these, 401 (85%) occurred in children with chronic medical conditions. In children <5 years the rates of nosocomial rotavirus gastroenteritis, with 95% confidence intervals, significantly decreased from 0.34 (0.25-0.45) per 100 admissions prevaccination to 0.09 (0.04-0.17) postvaccination and from 0,66 (0.48-0.88) to 0.16 (0.07-0.30) cases per 1000 hospital days. Postvaccination norovirus became the most frequent pathogen. Virus-positive cases were more common in young children and in winter months. Conclusions: Before the initiation of rotavirus vaccination, norovirus and rotavirus were equally common causes of nosocomial diarrhoea. Postvaccination, rotavirus was reduced by approximately 75% while the frequency of other viruses did not change.
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Affiliation(s)
- Selma Olsson-Åkefeldt
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Childhood Cancer Research Unit, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Maria Rotzén Östlund
- Department of Communicable Disease Control and Prevention, Stockholm County Council, Stockholm, Sweden
| | - Berit Hammas
- Department of Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Margareta Eriksson
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Rutger Bennet
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
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17
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Wang J, Zhang H, Zhang H, Fang H. Public health impact and cost-effectiveness of rotavirus vaccination in China: Comparison between private market provision and national immunization programs. Hum Vaccin Immunother 2022; 18:2090162. [PMID: 35816415 PMCID: PMC10019831 DOI: 10.1080/21645515.2022.2090162] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
In China, progress to include the RV vaccine in the national immunization program (NIP) is slow. The only two vaccines, the Lanzhou lamb rotavirus vaccine (LLR) and Rotateq, are provided through the private market. This study aims to assess the health impact and cost-effectiveness of using three vaccines in the NIP, Rotateq, Rotarix, and LLR, compared to the status quo. A decision-tree Markov model was adopted to follow the 2019 birth cohort, and a societal perspective was used. Input parameters were based on the latest local data when possible. Outcomes included cases and deaths averted, quality-adjusted life years (QALYs) gained, and incremental cost-effectiveness ratios (ICER). Sensitivity analyses and scenario analyses to consider herd immunity and vaccine price reduction were performed. Including Rotateq in the NIP was projected to prevent 348 million RVGE cases (62.6% reduction) and 4251 deaths (72.6% reduction) compared to the status quo. Rotarix through the NIP would prevent 48.7% of cases and 63.2% of deaths, and LLR would avert 20.3% of cases and 22.4% of deaths. The ICERs per QALY gained were US$ 8833 for Rotateq through the NIP, US$ 9503 for Rotarix, and US$ 26,759 for LLR. In uncertainty analyses, the reduction of vaccine prices and the incorporation of herd immunity further improved the cost-effectiveness of the NIPs, especially Rotateq or Rotarix. In conclusion, introducing the RV vaccine in China's NIP is expected to be cost-effective compared to the GDP per capita. Reducing vaccine prices and adopting vaccines with better efficacy would be the future focus.
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Affiliation(s)
- Jiahao Wang
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China.,China Center for Health Development Studies, Peking University, Beijing, China
| | - Haijun Zhang
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China.,China Center for Health Development Studies, Peking University, Beijing, China
| | - Haonan Zhang
- School of Health Humanities, Peking University, Beijing, China
| | - Hai Fang
- China Center for Health Development Studies, Peking University, Beijing, China.,Peking University Health Science Center-Chinese Center for Disease Control and Prevention Joint Center for Vaccine Economics, Beijing, China.,Key Laboratory of Reproductive Health National Health Commission of the People's Republic of China, Beijing, China
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18
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Marijam A, Schuerman L, Izurieta P, Pereira P, Van Oorschot D, Mehta S, Ota MOC, Standaert B. Estimated public health impact of human rotavirus vaccine (HRV) and pneumococcal polysaccharide protein D-conjugate vaccine (PHiD-CV) on child morbidity and mortality in Gavi-supported countries. Hum Vaccin Immunother 2022; 18:2135916. [PMID: 36507685 PMCID: PMC9766466 DOI: 10.1080/21645515.2022.2135916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Vaccine impact models against rotavirus disease (RD) and pneumococcal disease (PD) in low- and middle-income countries assume vaccine coverage based on other vaccines. We propose to assess the impact on severe disease cases and deaths avoided based on vaccine doses delivered by one manufacturer to Gavi-supported countries. From the number of human rotavirus vaccine (HRV) and pneumococcal polysaccharide protein D-conjugate vaccine (PHiD-CV) doses delivered, we estimated the averted burden of disease 1) in a specific year and 2) for all children vaccinated during the study period followed-up until 5 years (y) of age. Uncertainty of the estimated impact was assessed in a probabilistic sensitivity analysis using Monte-Carlo simulations to provide 95% confidence intervals. From 2009 to 2019, approximately 143 million children received HRV in 57 Gavi-supported countries, avoiding an estimated 18.7 million severe RD cases and 153,000, deaths. From 2011 to 2019, approximately 146 million children received PHiD-CV in 36 countries, avoiding an estimated 5.0 million severe PD cases and 587,000 deaths. The number of severe cases and deaths averted for all children vaccinated during the study period until 5 years of age were about 23.2 million and 190,000, respectively, for HRV, and 6.6 million and 749,000, respectively, for PHiD-CV. Models based on doses delivered help to assess the impact of vaccination, plan vaccination programs and understand public health benefits. In 2019, HRV and PHiD-CV doses delivered over a 5-y period may have, on average, averted nine severe disease cases every minute and one child death every 4 min.
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Affiliation(s)
- Alen Marijam
- GSK, Vaccines, Upper Providence, PA, USA,CONTACT Alen Marijam GSK, Upper Providence, PA, USA
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19
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Maimaiti H, Lu J, Guo X, Zhou L, Hu L, Lu Y. Vaccine Uptake to Prevent Meningitis and Encephalitis in Shanghai, China. Vaccines (Basel) 2022; 10:vaccines10122054. [PMID: 36560463 PMCID: PMC9787460 DOI: 10.3390/vaccines10122054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 11/26/2022] [Accepted: 11/28/2022] [Indexed: 12/05/2022] Open
Abstract
Multiple vaccines may prevent meningitis and encephalitis (M/E). In China, the meningococcal vaccine and Japanese encephalitis vaccine (JEV) have been included in the expanded program of immunization (EPI). The pneumococcal vaccine, Haemophilus influenzae type b (Hib) vaccine, rotavirus vaccine, and enterovirus 71 (EV-71) vaccine are non-EPI vaccines and are self-paid. We aim to investigate the uptake of these M/E vaccines in children and the related knowledge and health beliefs among family caregivers. A total of 1011 family caregivers with children aged 1-6 years in Shanghai, China were included in the study. The uptake of the pneumococcal vaccine, Hib-containing vaccine, rotavirus vaccine, and EV-71 vaccine remained at 44.0-48.1% in children, compared with the higher uptake of the meningococcal vaccine (88.8%) and JEV (87.1%). Moreover, family caregivers had limited knowledge on the M/E pathogens and possible vaccines. Their health beliefs were moderate to high. Then, a health belief model (HBM) and a structural equation model were established. The uptake of four non-EPI vaccines was significantly influenced by family income (β = 0.159), knowledge (β = 0.354), self-efficacy (β = 0.584), and perceived susceptibility (β = 0.212) within an HBM. Therefore, it warrants further improving the uptake rate for these non-EPI vaccines to prevent potential M/E in children. A specific health promotion may empower the caregivers' decision-making on childhood vaccination.
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Affiliation(s)
- Hairenguli Maimaiti
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai 200032, China
| | - Jia Lu
- Department of Immunization Planning, Minhang District Center for Disease Control and Prevention, Shanghai 201101, China
| | - Xiang Guo
- Institute of Immunization Planning, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
| | - Lu Zhou
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai 200032, China
| | - Linjie Hu
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai 200032, China
| | - Yihan Lu
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai 200032, China
- Correspondence:
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20
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Were FN, Jere KC, Armah GE, Mphahlele MJ, Mwenda JM, Steele AD. Maintaining Momentum for Rotavirus Immunization in Africa during the COVID-19 Era: Report of the 13th African Rotavirus Symposium. Vaccines (Basel) 2022; 10:vaccines10091463. [PMID: 36146541 PMCID: PMC9503285 DOI: 10.3390/vaccines10091463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/24/2022] [Accepted: 08/26/2022] [Indexed: 11/16/2022] Open
Abstract
The 13th African Rotavirus Symposium was held as a virtual event hosted by the University of Nairobi, Kenya and The Kenya Paediatric Association on 3rd and 4th November 2021. This biennial event organized under the auspices of the African Rotavirus Network shapes the agenda for rotavirus research and prevention on the continent, attracting key international and regional opinion leaders, researchers, and public health scientists. The African Rotavirus Network is a regional network of institutions initially established in 1999, and now encompassing much of the diarrheal disease and rotavirus related research in Africa, in collaboration with the World Health Organization African Regional Office (WHO-AFRO), Ministries of Health, and other partners. Surges in SARS-CoV2 variants and concomitant travel restrictions limited the meeting to a webinar platform with invited scientific presentations and scientific presentations from selected abstracts. The scientific program covered updates on burden of diarrheal diseases including rotavirus, the genomic characterization of rotavirus strains pre- and post-rotavirus vaccine introduction, and data from clinical evaluation of new rotavirus vaccines in Africa. Finally, 42 of the 54 African countries have fully introduced rotavirus vaccination at the time of the meeting, including the two recently WHO pre-qualified vaccines from India. Nonetheless, the full benefit of rotavirus vaccination is yet to be realized in Africa where approximately 80% of the global burden of rotavirus mortality exists.
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Affiliation(s)
- Frederick N. Were
- Department of Paediatrics and Child Health, University of Nairobi, Nairobi 00625, Kenya
- Kenya Paediatric Association, Nairobi 00100, Kenya
| | - Khuzwayo C. Jere
- Malawi-Liverpool-Wellcome Trust Clinical Research Program, Kamuzu University of Health Sciences, Blantyre 312225, Malawi
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool L69 7BE, UK
| | - George E. Armah
- Noguchi Memorial Institute of Medical Research, University of Ghana, Legon, Accra LG 581, Ghana
| | | | - Jason M. Mwenda
- WHO Regional Office for Africa, Brazzaville P.O. Box 2465, Congo
| | - A. Duncan Steele
- Department of Virology, Sefako Makgatho Health Sciences University, Pretoria 0204, South Africa
- Correspondence: ; Tel.: +1-(206)-915-3677
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21
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Burnett E, Parashar UD, Winn A, Curns AT, Tate JE. Major Changes in Spatiotemporal Trends of US Rotavirus Laboratory Detections After Rotavirus Vaccine Introduction-2009-2021. Pediatr Infect Dis J 2022; 41:759-763. [PMID: 35703247 PMCID: PMC9511972 DOI: 10.1097/inf.0000000000003598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
For the 15 years before rotavirus vaccine introduction in 2006, annual rotavirus activity in the United States showed a distinct spatiotemporal pattern, peaking first in the Southwest and last in the Northeast. We modeled spatiotemporal trends in rotavirus laboratory detections from 2009 to 2021. Laboratories reporting to the National Respiratory and Enteric Virus Surveillance System were eligible for inclusion in a given surveillance year (July to June) if ≥1 polymerase chain reaction or enzyme immunoassay rotavirus test per week was reported during ≥26 weeks and totaling ≥100 annual tests. For each laboratory, the season peak was the week with the highest 7-week moving average of the number of rotavirus positive tests during the national season, defined as the period with a 3-week moving average of >10% rotavirus positivity lasting ≥2 consecutive weeks. We input peak week as a continuous variable and the geospatial coordinates of each laboratory into a spherical variogram model for Kriging spatial interpolation. We also created a state-level bivariate choropleth map using tertiles of the 2010-2019 average birth rates and rotavirus vaccine coverage. Following the established biennial trend, the 2010-2011, 2012-2013, 2014-2015, 2016-2017, and 2018-2019 surveillance years had >10% rotavirus positivity for ≥2 weeks and were included in the geospatial analysis. During all 5 seasons included in the geospatial analysis, the earliest peak week occurred in Oklahoma, Arkansas, and the western Gulf coast, a pattern markedly different from prevaccine seasons. These states also had the average lowest rotavirus vaccine coverage and highest birth rate, suggesting that more rapid accumulation of susceptible children drives annual rotavirus season activity. Increasing vaccine coverage remains a key tool in reducing rotavirus burden.
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Affiliation(s)
- Eleanor Burnett
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - Umesh D. Parashar
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - Amber Winn
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - Aaron T. Curns
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - Jacqueline E. Tate
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA
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22
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Kempe A, O'Leary ST, Cortese MM, Crane LA, Cataldi JR, Brtnikova M, Beaty BL, Hurley LP, Gorman C, Tate JE, St Pierre JL, Lindley MC. Why Aren't We Achieving High Vaccination Rates for Rotavirus Vaccine in the United States? Acad Pediatr 2022; 22:542-550. [PMID: 34252608 PMCID: PMC9987347 DOI: 10.1016/j.acap.2021.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/30/2021] [Accepted: 07/01/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Rotavirus vaccine (RV) coverage levels for US infants are <80%. METHODS We surveyed nationally representative networks of pediatricians by internet/mail from April to June, 2019. Multivariable regression assessed factors associated with difficulty administering the first RV dose (RV#1) by the maximum age. RESULTS Response rate was 68% (303/448). Ninety-nine percent of providers reported strongly recommending RV. The most common barriers to RV delivery overall (definite/somewhat of a barrier) were: parental concerns about vaccine safety overall (27%), parents wanting to defer (25%), parents not thinking RV was necessary (12%), and parent concerns about RV safety (6%). The most commonly reported reasons for nonreceipt of RV#1 by 4 to 5 months (often/always) were parental vaccine refusal (9%), hospitals not giving RV at discharge from nursery (7%), infants past the maximum age when discharged from neonatal intensive care unit/nursery (6%), and infant not seen before maximum age for well care visit (3%) or seen but no vaccine given (4%). Among respondents 4% strongly agreed and 25% somewhat agreed that they sometimes have difficulty giving RV#1 before the maximum age. Higher percentage of State Child Health Insurance Program/Medicaid-insured children in the practice and reporting that recommendations for timing of RV doses are too complicated were associated with reporting difficulty delivering the RV#1 by the maximum age. CONCLUSIONS US pediatricians identified multiple, actionable issues that may contribute to suboptimal RV immunization rates including lack of vaccination prior to leaving nurseries after prolonged stays, infants not being seen for well care visits by the maximum age, missed opportunities at visits and parents refusing/deferring.
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Affiliation(s)
- Allison Kempe
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado (A Kempe, ST O'Leary, LA Crane, JR Cataldi, M Brtnikova, BL Beaty, LP Hurley, and C Gorman), Aurora, Colo; Department of Pediatrics, University of Colorado Anschutz Medical Campus (A Kempe, ST O'Leary, JR Cataldi, and M Brtnikova), Aurora, Colo.
| | - Sean T O'Leary
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado (A Kempe, ST O'Leary, LA Crane, JR Cataldi, M Brtnikova, BL Beaty, LP Hurley, and C Gorman), Aurora, Colo; Department of Pediatrics, University of Colorado Anschutz Medical Campus (A Kempe, ST O'Leary, JR Cataldi, and M Brtnikova), Aurora, Colo
| | - Margaret M Cortese
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (MM Cortese, JE Tate, JL St. Pierre, and MC Lindley), Atlanta, Ga
| | - Lori A Crane
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado (A Kempe, ST O'Leary, LA Crane, JR Cataldi, M Brtnikova, BL Beaty, LP Hurley, and C Gorman), Aurora, Colo; Department of Community and Behavioral Health, Colorado School of Public Health (LA Crane), Denver, Colo
| | - Jessica R Cataldi
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado (A Kempe, ST O'Leary, LA Crane, JR Cataldi, M Brtnikova, BL Beaty, LP Hurley, and C Gorman), Aurora, Colo; Department of Pediatrics, University of Colorado Anschutz Medical Campus (A Kempe, ST O'Leary, JR Cataldi, and M Brtnikova), Aurora, Colo
| | - Michaela Brtnikova
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado (A Kempe, ST O'Leary, LA Crane, JR Cataldi, M Brtnikova, BL Beaty, LP Hurley, and C Gorman), Aurora, Colo; Department of Pediatrics, University of Colorado Anschutz Medical Campus (A Kempe, ST O'Leary, JR Cataldi, and M Brtnikova), Aurora, Colo
| | - Brenda L Beaty
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado (A Kempe, ST O'Leary, LA Crane, JR Cataldi, M Brtnikova, BL Beaty, LP Hurley, and C Gorman), Aurora, Colo
| | - Laura P Hurley
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado (A Kempe, ST O'Leary, LA Crane, JR Cataldi, M Brtnikova, BL Beaty, LP Hurley, and C Gorman), Aurora, Colo; Division of General Internal Medicine, Denver Health (LP Hurley), Denver, Colo
| | - Carol Gorman
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado (A Kempe, ST O'Leary, LA Crane, JR Cataldi, M Brtnikova, BL Beaty, LP Hurley, and C Gorman), Aurora, Colo
| | - Jacqueline E Tate
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (MM Cortese, JE Tate, JL St. Pierre, and MC Lindley), Atlanta, Ga
| | - Jeanette L St Pierre
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (MM Cortese, JE Tate, JL St. Pierre, and MC Lindley), Atlanta, Ga
| | - Megan C Lindley
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (MM Cortese, JE Tate, JL St. Pierre, and MC Lindley), Atlanta, Ga
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23
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Zhang X, Xu XF, Jin J. Rotavirus vaccination and the risk of type 1 diabetes and celiac disease: A systematic review and meta-analysis. Front Pediatr 2022; 10:951127. [PMID: 36090563 PMCID: PMC9459138 DOI: 10.3389/fped.2022.951127] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 07/29/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Rotavirus vaccination has been proven to effectively protect against rotavirus gastroenteritis. However, there are concerns about the relationship between rotavirus vaccination and the risk of autoimmune disorders. Thus, we conducted a systematic review and meta-analysis to comprehensively assess the association between rotavirus vaccination and type 1 diabetes (T1D) or celiac disease (CD) risk. METHODS A systematic review and meta-analysis were conducted to evaluate the type 1 diabetes or celiac disease associated with rotavirus vaccination. The following journal databases were searched to identify potential studies for inclusion: PubMed, Embase, and Cochrane Library databases. RESULTS Seven articles involving more than 5,793,055 children were included. Our results showed that rotavirus vaccination does not alter the subsequent risk of T1D (RR 0.94, 95% CI: 0.82-1.09) or CD (RR 0.86, 95% CI: 0.64-1.17) after vaccination. Furthermore, the risk of T1D was not increased or decreased for children fully exposed to rotavirus vaccination (RR 0.86, 95% CI, 0.54-1.36) and for children partially exposed to rotavirus vaccination (RR 1.05, 95% CI, 0.87-1.26). However, younger (<5 years) vaccinated children at the end of study (RR 0.84, 95% CI = 0.75-0.95) may be at a lower risk for T1D than older (≥5 years) vaccinated children (RR 0.93, 95% CI, 0.81-1.07). CONCLUSION The findings of this study suggest that rotavirus vaccination does not appear to be associated with T1D or CD in children. The protective effect of rotavirus vaccination on T1D may be presented by time dependent.
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Affiliation(s)
- Xue Zhang
- Department of Infectious Diseases, The Affiliated Hangzhou First People's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiang-Fei Xu
- Department of Infectious Diseases, The Affiliated Hangzhou First People's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jie Jin
- Department of Infectious Diseases, The Affiliated Hangzhou First People's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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24
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Hoshina T, Kawase M, Watanabe S, Shibahara J, Kojiro M, Miyake T, Sakaguchi Y, Kajiwara Y, Kusuhara K. Trends in voluntary vaccination coverage in a Japanese city. Pediatr Int 2021; 63:1466-1471. [PMID: 33780596 DOI: 10.1111/ped.14712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/18/2021] [Accepted: 03/26/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Large numbers of patients with diseases preventable by voluntary vaccines have been reported in Japan. However, it is difficult to analyze the impact of voluntary vaccination on disease prevention, as governments do not aggregate the number of recipients of vaccines that are not included in the national immunization program. This study investigated the association between the coverage rates of two voluntary vaccines (rotavirus and mumps vaccines) and the incidence of the diseases preventable by these vaccines. METHODS We performed a prospective questionnaire-based observational study to investigate the presumptive coverage rates of the rotavirus vaccine in infancy and the mumps vaccine at 1 year of age in Kitakyushu City from 2015 to 2018. The number of children admitted to a secondary medical institution for rotavirus-associated gastroenteritis and the incidence of mumps infection in sentinel medical institutions were also analyzed during the investigation period. RESULTS The rotavirus and mumps vaccine coverage rates since 2016 were 61-63% and late 28-30%, respectively (52.6% and 20.3% in 2015, respectively). The yearly number of children hospitalized for rotavirus-associated gastroenteritis from 2015 to 2018 declined by 41.4% compared with that during the pre-vaccination period (2009-2011). The incidence of mumps infection remained unchanged during the investigation period. CONCLUSION The coverage rates of two voluntary vaccines were not high enough to control the infections. The incorporation of voluntary vaccines into the routine immunization program should be considered as the one of the effective ways to increase vaccination coverage.
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Affiliation(s)
- Takayuki Hoshina
- Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Mayumi Kawase
- Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.,Department of Pediatrics, Kitakyushu General Hospital, Kitakyushu, Japan
| | - Shunsuke Watanabe
- Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.,Department of Pediatrics, Kitakyushu General Hospital, Kitakyushu, Japan
| | - Junpei Shibahara
- Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.,Department of Pediatrics, Kitakyushu General Hospital, Kitakyushu, Japan
| | - Masumi Kojiro
- Department of Pediatrics, Kitakyushu General Hospital, Kitakyushu, Japan
| | - Takumi Miyake
- Kitakyushu Society of Child Health, Kitakyushu, Japan.,Miyake Clinic, Kitakyushu, Japan
| | - Yusuke Sakaguchi
- Kitakyushu Society of Child Health, Kitakyushu, Japan.,Sakaguchi Children Clinic, Kitakyushu, Japan
| | - Yasuhiro Kajiwara
- Kitakyushu Society of Child Health, Kitakyushu, Japan.,Department of Pediatrics, Tobata General Hospital, Kitakyushu, Japan
| | - Koichi Kusuhara
- Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
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25
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Abstract
This review examines the risk of developing celiac disease (CD) and other autoimmune diseases in individuals receiving the rotavirus (RV) vaccine compared to the normal population. Celiac disease is a malabsorptive, chronic, immune-mediated enteropathy involving the small intestine. The pathogenesis of CD is multifactorial, and mucosal immunity plays an important role in its development. Low mucosal IgA levels significantly increase the risk of developing the disease. Rotavirus is an infectious agent that causes diarrhea, particularly in children aged 0-24 months, and is frequently involved in diarrhea-related deaths in these children. An oral vaccine against RV has been developed. While it is effective on RV infection, it also contributes to increasing mucosal immunity. Studies have indicated that individuals immunized with the RV vaccine are at lower risk of developing CD than unvaccinated individuals. In addition, the mean age for developing CD autoimmunity may be higher in the vaccinated group than in controls receiving placebo. Additional studies that include children immunized with different RV vaccines and unvaccinated children would provide more meaningful results. Although current data suggest a possible association of RV vaccination with a reduced risk of developing CD and other autoimmune diseases, this remains an unanswered question that merits greater international investigation.
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Ito M, Higashigawa M. Effectiveness of self-financed rotavirus vaccination in Ise City, Japan. Hum Vaccin Immunother 2021; 17:5650-5655. [PMID: 34641737 DOI: 10.1080/21645515.2021.1972706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
In Japan, the herd immunity effect of rotavirus vaccine has not yet been proven. Here, we conducted active surveillance for hospitalization due to rotavirus acute gastroenteritis (AGE) among children under 5 years of age in pre-rotavirus vaccination years and self-financed rotavirus vaccination years to clarify the rotavirus vaccine effectiveness (VE) in reducing hospitalization rates. A time-series analysis showed that the monthly hospitalization rates observed after vaccine introduction were significantly lower than the forecasted hospitalization rates (p < .001, Mann-Whitney U test). In the third year after vaccine introduction, the hospitalization rate declined despite the low vaccination rate of 27-50% for the two preceding years. We estimated four types of VE, namely direct, indirect, total, and overall. The direct VE was calculated from the relative risk ratio of hospitalizations between vaccinated and unvaccinated children. The indirect VE was defined as the population-level effects of vaccination on children not receiving the vaccine. The total VE was defined as the combination of the direct and indirect VE on children receiving the vaccine. The overall VE was determined by the weighted average of indirect VE on the children not receiving the vaccine and the total VE on the children receiving the vaccine. The direct, indirect, total, and overall VE values were calculated as 82% (95% confidence interval, 52-93), 70% (51-82), 95% (87-98), and 86% (77-91), respectively. The high values of indirect, total, and overall VE indicate that the rotavirus vaccine produces a herd immunity effect.
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Affiliation(s)
- Mitsue Ito
- Department of Pediatrics/Neonatology, Japanese Red Cross Ise Hospital, Ise City, Japan
| | - Masamune Higashigawa
- Department of Pediatrics/Neonatology, Japanese Red Cross Ise Hospital, Ise City, Japan
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Haber M, Tate JE, Lopman BA, Qi W, Ainslie KEC, Parashar UD. Comparing statistical methods for detecting and estimating waning efficacy of rotavirus vaccines in developing countries. Hum Vaccin Immunother 2021; 17:4632-4635. [PMID: 34613877 DOI: 10.1080/21645515.2021.1968738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
INTRODUCTION Vaccination has significantly reduced morbidity and mortality resulting from rotavirus infection worldwide. However, rotavirus vaccine efficacy (VE) appears to wane over the first 2 years since vaccination, particularly in developing countries. Statistical methods for detecting VE waning and estimating its rate have been used in a few studies, but comparisons of methods for evaluating VE waning have not yet been performed. In this work we present and compare three methods - Durham's method, Tian's method, and time-dependent covariate (TDC) method - based on generalizations of the Cox proportional hazard model. METHODS We developed a new stochastic agent-based simulation model to generate data from a hypothetical rotavirus vaccine trial where the protective efficacy of the vaccine may vary over time. Input parameters to the simulation model were obtained from studies on rotavirus infections in four developing countries. We applied each of the methods to four simulated datasets and compared the type-1 error probabilities and the powers of the resulting statistical tests. We also compared estimated and true values of VE over time. RESULTS Durham's method had the highest power of detecting true VE waning of the three methods. This method also provided quite accurate estimates of VE in each period and of the per-period drop in VE. CONCLUSIONS Durham's method is somewhat more powerful than the other two Cox proportional hazards model-based methods for detecting VE waning and provides more information about the temporal behavior of VE.
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Affiliation(s)
- Michael Haber
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, USA
| | | | - Benjamin A Lopman
- Centers for Disease Control and Prevention, Atlanta, GA, USA.,Department of Epidemiology, Emory University, Atlanta, GA, USA
| | - Wenrui Qi
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, USA
| | - Kylie E C Ainslie
- Mrc Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College, London, UK
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Schollin Ask L, Wingren L, Storsaeter J. National guidelines recommend rotavirus vaccination to inpatient preterm infants. Acta Paediatr 2021; 110:2680-2685. [PMID: 34091936 DOI: 10.1111/apa.15968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/27/2021] [Accepted: 06/02/2021] [Indexed: 01/31/2023]
Abstract
AIM The aim was to perform a literature search of the latest evidence of administration of dose 1 of rotavirus vaccine to children admitted in neonatal intensive care or special care unit settings. METHODS The literature search focused on the outcome of serious adverse events of rotavirus vaccination in vaccinated children and on possible symptomatic infection in controls and in unvaccinated children via transmission of the vaccine virus in the same ward. Results and guidelines were discussed with a working group selected from the national advisory group of child health. Also, a survey to neonatal care units in Sweden was sent out due to the subject. RESULTS Administration of rotavirus vaccine is safe for age-eligible preterm children and unvaccinated children in the same ward. A satisfactory immune response has been shown, and basic hygiene routines are enough. Also, hospitalised age-eligible children with paediatric surgical conditions should be considered the rotavirus vaccine. CONCLUSION The Swedish Public Health Agency recommends that preterm infants as well as children who are admitted for other reasons in the neonatal ward be vaccinated with dose 1 against rotavirus infection when hospitalised and when age eligible.
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Affiliation(s)
| | - Lisen Wingren
- Sachsska Children and Youth Hospital Stockholm Sweden
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Abstract
Live, oral rotavirus vaccines are more effective at preventing rotavirus disease in countries with low child mortality compared with high child mortality. Among several hypotheses, poorer protection in malnourished children, who are more prevalent in countries with high child mortality, may partially explain this difference. We conducted a literature search to identify articles with a laboratory-confirmed rotavirus endpoint that evaluated differences by malnutrition status in rotavirus vaccine effectiveness and vaccine efficacy (VE) or the prevalence of rotavirus infection or illness among children <5 years old. We identified 7 analyses from 11 countries published from 2007 to 2019 that stratified rotavirus VE by malnutrition status. Among well-nourished children, VE point estimates ranged from 71% to 84% in observational studies and 26% to 61% in clinical trials. Among malnourished children, they ranged from -28% to 45% in observational studies and -3% to 61% in clinical trials. The relative difference between VE in well-nourished and malnourished children by length-for-age ranged from 37% to 64%, by weight-for-age ranged from 0% to 107%, and by weight-for-height ranged from -65% to 137%. We identified 3 cohort and 6 cross-sectional studies of natural rotavirus infection and illness and none reported that malnourished children were more susceptible to rotavirus infection or illness than well-nourished children. Overall, rotavirus vaccines may offer less protection to children with malnutrition than well-nourished children. As malnourished children often have worse outcomes from diarrhea, high rotavirus vaccine coverage and a better understanding of the performance of oral rotavirus vaccines in this population is important, though our finding that malnourished children may be less susceptible to rotavirus provides important context and information for vaccine evaluation design.
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Affiliation(s)
- Eleanor Burnett
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Umesh D. Parashar
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jacqueline E. Tate
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Omatola CA, Ogunsakin RE, Olaniran AO. Prevalence, Pattern and Genetic Diversity of Rotaviruses among Children under 5 Years of Age with Acute Gastroenteritis in South Africa: A Systematic Review and Meta-Analysis. Viruses 2021; 13:1905. [PMID: 34696335 PMCID: PMC8538439 DOI: 10.3390/v13101905] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/03/2021] [Accepted: 09/15/2021] [Indexed: 12/26/2022] Open
Abstract
Rotavirus is the most significant cause of severe acute gastroenteritis among children under 5 years of age, worldwide. Sub-Saharan Africa particularly bears the brunt of the diarrheal deaths. A meta-analysis was conducted on 43 eligible studies published between 1982 and 2020 to estimate the pooled prevalence of rotavirus infection and changes in the main rotavirus strains circulating before and after vaccine introduction among under-five children in South Africa. The pooled national prevalence of rotavirus infection was estimated at 24% (95% CI: 21-27%) for the pre-vaccination period and decreased to 23% (95% CI: 21-25%) in the post-vaccination period. However, an increased number of cases was observed in the KwaZulu-Natal (21-28%) and Western Cape (18-24%) regions post-vaccination. The most dominant genotype combinations in the pre-vaccine era was G1P[8], followed by G2P[4], G3P[8], and G1P[6]. After vaccine introduction, a greater genotype diversity was observed, with G9P[8] emerging as the predominant genotype combination, followed by G2P[4], G12P[8], and G1P[8]. The introduction of the rotavirus vaccine was associated with a reduction in the burden of rotavirus-associated diarrhea in South Africa, although not without regional fluctuation. The observed changing patterns of genotype distribution highlights the need for ongoing surveillance to monitor the disease trend and to identify any potential effects associated with the dynamics of genotype changes on vaccine pressure/failure.
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Affiliation(s)
- Cornelius A. Omatola
- Discipline of Microbiology, School of Life Sciences, College of Agriculture, Engineering and Science, University of KwaZulu-Natal (Westville Campus), Private Bag X54001, Durban 4000, South Africa;
| | - Ropo E. Ogunsakin
- Discipline of Public Health Medicine, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal (Westville Campus), Private Bag X54001, Durban 4000, South Africa;
| | - Ademola O. Olaniran
- Discipline of Microbiology, School of Life Sciences, College of Agriculture, Engineering and Science, University of KwaZulu-Natal (Westville Campus), Private Bag X54001, Durban 4000, South Africa;
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Tagbo BN, Ezomike UO, Odetunde OA, Edelu BO, Eke BC, Amadi OF, Okeke IB, Ani O, Chukwubuike CM, Mwenda JM, Ekenze SO. Intussusception in children under five years of age in Enugu, Nigeria. Pan Afr Med J 2021; 39:9. [PMID: 34548901 PMCID: PMC8437421 DOI: 10.11604/pamj.supp.2021.39.1.20811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 05/13/2020] [Indexed: 11/11/2022] Open
Abstract
Introduction intussusception is the invagination of a segment of the bowel into a distal segment. It occurs predominantly in infants worldwide. Following documentation of increased incidence after introduction of the first rotavirus vaccine (Rotashield, Wyeth-Lederle), it has become a standard recommendation to maintain surveillance for intussusception as newer rotavirus vaccines are introduced into EPI. Nigeria plans to introduce rotavirus vaccine in 2020. Pre-vaccine introduction surveillance will serve as a baseline to understand the epidemiology of intussusception in Nigeria. Methods from 2013 to 2017, prospective enrolment of under five children with intussusception was done following the WHO protocol and using the WHO case report form. Only children who met the Pan American Health Organization/World Health Organization (PAHO/WHO) protocol case definition for intussusception were enrolled. These children were monitored until discharge or death. Clinical features and outcome were recorded in the case report form. Results a total of 63 cases were enrolled, with age range of 3 to 42 months (median: 6 months, IQR: 5-9 months). Majority were within 4-6 months and 96% were < 12 months old. There were 41 males and 22 females (male to female ratio of 1.9:1). Duration of symptoms before presentation ranged from 2 hours to 15 days (median: 72 hours). Fifty-seven patients had abdominal ultrasound and 52 patients (83%) had surgery. Case fatality rate was 9% and duration of hospitalization ranged from 1 to 30 days (median 10 days, IQR 8-15 days). Conclusion intussusception occurred most commonly in infants but well beyond the proposed age for rotavirus vaccination in the population studied. Late presentation and surgical intervention were common. This data provides a good baseline description of the epidemiology of intussusception.
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Affiliation(s)
- Beckie Nnenna Tagbo
- Institute of Child Health & Department of Paediatrics, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | | | | | | | | | | | | | - Okechukwu Ani
- Department of Paediatrics, Enugu State University Teaching Hospital, Enugu, Nigeria
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Peck ME, Hampton LM, Antoni S, Ogbuanu I, Serhan F, Nakamura T, Walldorf JA, Cohen AL. Global Rotavirus and Pneumococcal Conjugate Vaccine Introductions and the Association With Country Disease Surveillance, 2006-2018. J Infect Dis 2021; 224:S184-S193. [PMID: 34469564 PMCID: PMC8414915 DOI: 10.1093/infdis/jiab069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND To inform the introduction of pneumococcal conjugate vaccine (PCV) and rotavirus vaccine, the World Health Organization (WHO) established the Global Invasive Bacterial Vaccine-Preventable Disease Surveillance Network (GISN) and the Global Rotavirus Surveillance Network (GRSN) in 2008. We investigated whether participation in these networks or other surveillance was associated with vaccine introduction. METHODS Between 2006 and 2018, among all WHO member states, we used multivariable models adjusting for economic status to assess (1) the association between surveillance for pneumococcal disease or rotavirus disease, including participation in GISN or GRSN and the introduction of the PCV or the rotavirus vaccine, respectively, and (2) the association between the rotavirus disease burden and the rotavirus vaccine introduction among 56 countries participating in GRSN from 2008 to 2018. RESULTS Countries that participated in or conducted surveillance for invasive pneumococcal disease or rotavirus disease were 3.5 (95% confidence interval [CI], 1.7-7.1) and 4.2 (95% CI, 2.1-8.6) times more likely to introduce PCV or rotavirus respectively, compared to those without surveillance. Among countries participating in GRSN, there was insufficient evidence to demonstrate an association between countries with higher rotavirus positivity and vaccine introduction. CONCLUSIONS Surveillance should be incorporated into advocacy strategies to encourage the introduction of vaccines, with countries benefiting from data from, support for, and coordination of international disease surveillance networks.
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Affiliation(s)
- Megan E Peck
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lee M Hampton
- Monitoring and Evaluation, Gavi, the Vaccine Alliance, Geneva, Switzerland
| | - Sebastian Antoni
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Ike Ogbuanu
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Fatima Serhan
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Tomoka Nakamura
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Jenny A Walldorf
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Adam L Cohen
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
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Abstract
INTRODUCTION As of January 2021, rotavirus vaccination programs have been implemented in 109 countries and their use has resulted in a positive impact on rotavirus-related diarrheal hospitalizations and mortality in children below 5 years of age. Despite these successes, several countries in Africa and Asia where disease burden is high have not yet implemented rotavirus vaccination at all or at a scale sufficient enough to demonstrate impact. This could be, among other reasons, due to poor vaccine coverage and the modest levels of efficacy and effectiveness of the vaccines in these resource-limited settings. AREAS COVERED We review various factors related to the human host (malnutrition, maternally derived antibodies and breastfeeding, genetic factors, blood group, and co-administration with oral polio vaccine), rotavirus pathogen (force of infection, strain diversity and coinfections), and the environment (related to the human microbiome) which reflect complex and interconnected processes leading to diminished vaccine performance in resource-limited settings. EXPERT OPINION Addressing the limiting factors for vaccine efficacy is needed but likely to take a long time to be resolved. An immediate solution is to increase the immunization coverage to higher values generating an overall effect of adequate proportion of protected population to reduce the prevalence of rotavirus disease.
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Guzman-Holst A, Ortega-Barria E, Flores ÁA, Carreño-Manjarrez R, Constenla D, Cervantes-Apolinar MY. 15-year experience with rotavirus vaccination in Mexico: a systematic literature review. Hum Vaccin Immunother 2021; 17:3623-3637. [PMID: 34187326 PMCID: PMC8437458 DOI: 10.1080/21645515.2021.1936859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A systematic review was conducted in Mexico to consolidate and evaluate evidence after 15 years of rotavirus vaccination, according to the National Immunization Program. Five databases were screened to identify published articles (January 2000-February 2020) with evidence on all clinical and epidemiological endpoints (e.g. immunogenicity, safety, efficacy, impact/effectiveness) of rotavirus vaccination in Mexico. Twenty-two articles were identified (observational studies including health-economic models: 17; randomized controlled trials: 5). Fourteen studies evaluated a human attenuated vaccine (HRV), four studies evaluated both vaccines, and only two evaluated a bovine-human reassortant vaccine, with local efficacy data only for HRV. Local evidence shows vaccines are safe, immunogenic, efficacious, and provide an acceptable risk-benefit profile. The benefits of both vaccines in alleviating the burden of all-cause diarrhea mortality and morbidity are documented in several local post-licensure studies. Findings signify overall benefits of rotavirus vaccination and support the continued use of rotavirus vaccine in Mexico.
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Chandra P, Lo M, Mitra S, Banerjee A, Saha P, Okamoto K, Deb AK, Ghosh SK, Manna A, Dutta S, Chawla-Sarkar M. Genetic characterization and phylogenetic variations of human adenovirus-F strains circulating in eastern India during 2017-2020. J Med Virol 2021; 93:6180-6190. [PMID: 34138479 DOI: 10.1002/jmv.27136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 05/10/2021] [Accepted: 06/05/2021] [Indexed: 01/27/2023]
Abstract
Human adenovirus-F (HAdV-F) (genotype 40/41) is the second-most leading cause of pediatric gastroenteritis after rotavirus, worldwide, accounting for 2.8%-11.8% of infantile diarrheal cases. Earlier studies across eastern India revealed a shift in the predominance of genotypes from HAdV41 in 2007-09 to HAdV40 in 2013-14. Thus, the surveillance for HAdV-F genotypes in this geographical setting was undertaken over 2017-2020 to analyze the viral evolutionary dynamics. A total of 3882 stool samples collected from children (≤5 years) were screened for HAdV-F positivity by conventional PCR. The hypervariable regions of the hexon and the partial shaft region of long fiber genes were amplified, sequenced, and phylogenetically analyzed with respect to the prototype strains. A marginal decrease in enteric HAdV prevalence was observed (9.04%, n = 351/3882) compared to the previous report (11.8%) in this endemic setting. Children <2 years were found most vulnerable to enteric HAdV infection. Reduction in adenovirus-rotavirus co-infection was evident compared to the sole adenovirus infection. HAdV-F genotypes 40 and 41 were found to co-circulate, but HAdV41 was predominant. HAdV40 strains were genetically conserved, whereas HAdV41 strains accumulated new mutations. On the basis of a different set of mutations in their genome, HAdV41 strains segregated into 2 genome type clusters (GTCs). Circulating HAdV41 strains clustered with GTC1 of the fiber gene, for the first time during this study period. This study will provide much-needed baseline data on the emergence and circulation of HAdV40/41 strains for future vaccine development.
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Affiliation(s)
- Pritam Chandra
- Division of Virology, National Institute of Cholera and Enteric Diseases, Beliaghata, Kolkata, West Bengal, India
| | - Mahadeb Lo
- Division of Virology, National Institute of Cholera and Enteric Diseases, Beliaghata, Kolkata, West Bengal, India
| | - Suvrotoa Mitra
- Division of Virology, National Institute of Cholera and Enteric Diseases, Beliaghata, Kolkata, West Bengal, India
| | - Anindita Banerjee
- Division of Virology, National Institute of Cholera and Enteric Diseases, Beliaghata, Kolkata, West Bengal, India
| | - Priyanka Saha
- Division of Virology, National Institute of Cholera and Enteric Diseases, Beliaghata, Kolkata, West Bengal, India
| | - Keinosuke Okamoto
- Collaborative Research Centre of Okayama University for Infectious Disease at Indian ICMR-National Institute of Cholera and Enteric Diseases, Beliaghata, Kolkata, West Bengal, India
| | - Alok Kumar Deb
- Division of Epidemiology, ICMR-National Institute of Cholera and Enteric Diseases, Beliaghata, Kolkata, West Bengal, India
| | - Sanat Kumar Ghosh
- Dr. B.C. Roy Post Graduate Institute of Pediatric Sciences, Kolkata, West Bengal, India
| | - Asis Manna
- Infectious diseases and Beliaghata General (ID & BG) Hospital, Beliaghata, Kolkata, West Bengal, India
| | - Shanta Dutta
- Regional Virus Research and Diagnostic Laboratory, ICMR-National Institute of Cholera and Enteric Diseases, Beliaghata, Kolkata, West Bengal, India
| | - Mamta Chawla-Sarkar
- Division of Virology, National Institute of Cholera and Enteric Diseases, Beliaghata, Kolkata, West Bengal, India
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Gopalkrishna V, Ganorkar N, Patil P, Hedda G, Ranshing S, Kulkarni R. Clinical, epidemiological, and molecular aspects of picornaviruses (entero, parecho) in acute gastroenteritis: A study from Pune (Maharashtra), Western India. J Med Virol 2021; 93:3590-3600. [PMID: 32997382 DOI: 10.1002/jmv.26571] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 09/13/2020] [Accepted: 09/28/2020] [Indexed: 11/05/2022]
Abstract
Among enteric viruses, rotavirus A (RVA), norovirus (NoV), adenovirus, and astrovirus (AstV) are the major etiological agents associated in acute gastroenteritis. The present study highlights, clinical, epidemiological, and molecular aspects with respect to RVA, NoV, enterovirus (EV), and human parechovirus (HPeVs) in sporadic cases (n = 305) of acute gastroenteritis, Pune (Maharashtra), Western India. Detection of RVA was carried out by enzyme-linked immunosorbent assay, NoV, EV, and HPeVs by reverse transcription PCR. Prevalence of 36.06%, 20.32%, 14.09%, 3.93%, respectively was observed for RVA, EV, HPeVs, and NoV along with coinfections. Infections occurred in children less than 2 years old, with peak infections within 12 months age. The disease severity in RV infections was found high (70.90%) with severe disease, followed by EV (62.9%), NoV (58.33%), and HPeV (44.58%). Predominant strains of RV G1P[8], G2P[4] types with unusual G9P[4], NoV Genogroup II of genotype 4 strains and multiple EV types with EV-B species, E14 and E17 and two novel EV-75, EV-107 types were detected. Circulation of heterogeneous HPeV genotypes (HPeV1-5, 7, 8, 13, 14, 16) with predominance of HPeV-1 was noticed. Changing trends in circulation of a rare HPeV-2 genotype, with emerging and reemerging strains was noted. The study highlights association of RVA, NoV, EV, and HPeV and their mono-infections, genotype distribution, and changing trends in acute gastroenteritis, and added more knowledge on rota and nonrota enteric viruses in acute gastroenteritis. More such studies in rota vaccinated era are required across the country, as Indian rotavirus vaccine has been implemented under the National Immunization program.
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Affiliation(s)
| | - Nital Ganorkar
- Enteric Viruses Group, National Institute of Virology, Pune, India
| | - Pooja Patil
- Enteric Viruses Group, National Institute of Virology, Pune, India
| | - Gokul Hedda
- Enteric Viruses Group, National Institute of Virology, Pune, India
| | - Sujata Ranshing
- Enteric Viruses Group, National Institute of Virology, Pune, India
| | - Ruta Kulkarni
- Enteric Viruses Group, National Institute of Virology, Pune, India
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Gower CM, Stowe J, Andrews NJ, Dunning J, Ramsay ME, Ladhani SN. Sustained declines in age group-specific rotavirus infection and acute gastroenteritis in vaccinated and unvaccinated individuals during the five years since Rotavirus vaccine introduction in England. Clin Infect Dis 2021; 74:437-445. [PMID: 34043765 DOI: 10.1093/cid/ciab460] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The introduction of an oral live-attenuated monovalent rotavirus vaccine (Rotarix ®) into the UK infant immunisation programme in July 2013 was associated with large reductions in laboratory-confirmed rotavirus infections and hospitalisations due to acute gastroenteritis (AGE) within 12 months. Here we report the five-year impact of the programme in England. METHODS Individuals with laboratory-confirmed rotavirus infections during 2000-2018 and all-cause hospitalisations for AGE during 2007-2018 were identified using national electronic records. Age-specific incidence rate ratios (IRR) and estimated numbers of cases averted in each of the five post-vaccination years were calculated. RESULTS There were 206,389 laboratory-confirmed rotavirus infections and 3,657,651 hospitalisations for all-cause AGE. Reductions of 69-83% in laboratory-confirmed rotavirus infections in all age groups and 77-88% in infants aged <1 year in each of the five post-vaccine years are reported, with 11,386-11,633 cases averted annually. All-cause AGE hospitalisations were reduced by 12-35% across all age-groups and by 25-48% in <1 year-olds in the five post-vaccine years, with 24,474-49,278 hospitalisations averted annually. There was strong evidence of indirect (herd) protection, with at least 50% and up to 80% of the non-specific end point of all-cause gastroenteritis (AGE) hospitalisations averted being in unvaccinated age-groups, primarily older adults. Seasonal changes include a possible shift from annual to biennial peaks with lower peak incidence and longer seasons. CONCLUSIONS There were large and sustained declines in both laboratory-confirmed rotavirus infections and AGE hospitalisations across all age groups in each of the five years since the introduction of the UK rotavirus programme.
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Affiliation(s)
- Charlotte M Gower
- Immunisation and Counter-Measures Division, National Infection Service, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, UK
| | - Julia Stowe
- Immunisation and Counter-Measures Division, National Infection Service, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, UK
| | - Nick J Andrews
- Statistics, Modelling and Economics Department, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Jake Dunning
- Tuberculosis; Acute Respiratory, Gastrointestinal, Emerging and Zoonotic Infections; and Travel and Migrant Health Division (TARGET), National Infection Service, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, UK
| | - Mary E Ramsay
- Immunisation and Counter-Measures Division, National Infection Service, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, UK
| | - Shamez N Ladhani
- Immunisation and Counter-Measures Division, National Infection Service, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, UK.,Paediatric Infectious Disease Research Group St. George's University of London, Cranmer Terrace, London SW17 ORE, UK
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Newall AT, Leong RN, Reyes JF, Curns AT, Rudd J, Tate J, Macartney K, Parashar U. Rotavirus vaccination likely to be cost saving to society in the United States. Clin Infect Dis 2021; 73:1424-1430. [PMID: 34038527 DOI: 10.1093/cid/ciab442] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Following the introduction of rotavirus immunization in 2006 in the United States (US) there were substantial declines in the domestic rotavirus disease burden. In this study we assess the value for money achieved by the program in the decade following vaccine introduction. METHODS We applied an age-specific static multi-cohort compartmental model to examine the impact and cost-effectiveness of the US rotavirus immunization program in children <5 years of age using healthcare utilization data from 2001-2015 inclusive. We calculated the incremental cost-effectiveness ratio (ICER) per quality-adjusted life year (QALY) gained from both a healthcare system and societal perspective. RESULTS Declines in healthcare utilization associated with the rotavirus and acute gastroenteritis occurred from 2006 and continued to grow before stabilizing from 2010-2011. From 2011-2015, an estimated annual average of approximately 118,000 hospitalizations, 86,000 emergency department presentations and 460,000 outpatient and physician office visits were prevented. From a societal perspective during this same period the program was estimated to be cost saving in the base case model and in >90% of probabilistic sensitivity analysis simulations and from a healthcare system perspective >98% of simulations found an ICER below $100,000 per QALY gained. CONCLUSIONS After the program stabilized, we found the rotavirus immunization in the US was likely to have been cost saving to society. The greater than expected healthcare and productivity savings reflect the success of the rotavirus immunization program in the US.
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Affiliation(s)
- Anthony T Newall
- School of population health, Faculty of Medicine, UNSW Sydney, Australia
| | - Robert Neil Leong
- School of population health, Faculty of Medicine, UNSW Sydney, Australia
| | - Josephine F Reyes
- School of population health, Faculty of Medicine, UNSW Sydney, Australia
| | - Aaron T Curns
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, USA
| | - Jessica Rudd
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, USA.,MAXIMUS Federal, Atlanta, Georgia, USA
| | - Jacqueline Tate
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, USA
| | - Kristine Macartney
- National Centre for Immunisation Research and Surveillance and The Children's Hospital Westmead, Sydney, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Umesh Parashar
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, USA
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Gopalkrishna V, Joshi MS, Chavan NA, Shinde MS, Walimbe AM, Sawant PM, Kalrao VR, Dhongade RK, Bavdekar AR. Prevalence and genetic diversity of gastroenteritis viruses in hospitalized children < 5 years of age in Maharashtra state, Western India, 2017-2019. J Med Virol 2021; 93:4805-4816. [PMID: 33990988 DOI: 10.1002/jmv.27085] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 04/07/2021] [Accepted: 05/11/2021] [Indexed: 12/16/2022]
Abstract
Four gastroenteritis viruses were responsible for 54% of the acute gastroenteritis (AGE) cases in children hospitalized between May 2017 and December 2019 in Pune city of Maharashtra state, Western India. The majority (79%) of the children were <2 years of age. The prevalence of Rotavirus A (RVA) was 30.5% followed by 14.3% for norovirus, 8.4% for adenovirus, and 5.5% for astrovirus. The severity of the disease was highest in patients with coinfections compared with the patients with a single infection or negative for all (p = 0.024). Genotyping analysis showed that the majority of the RVA-positive samples (66%) could be typed as G3P[8], 63.6% of the norovirus as GII.4 Sydney [P16], 44% of the adenovirus as type 41%, and 56.2% of the astrovirus as astrovirus type 1. The almost equivalent prevalence of rotavirus and nonrotaviruses and acute gastroenteritis (AGE) cases without known etiology in around 46% of the cases was noted in the present study. Our data highlight that after the recent inclusion of rotavirus vaccines as a part of the National Immunization schedule in India, conducting extensive AGE surveillance in children should include nonrotaviruses such as norovirus.
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Affiliation(s)
| | - Madhuri S Joshi
- Enteric Viruses Group, ICMR-National Institute of Virology, Pune, India
| | - Nutan A Chavan
- Enteric Viruses Group, ICMR-National Institute of Virology, Pune, India
| | - Manohar S Shinde
- Enteric Viruses Group, ICMR-National Institute of Virology, Pune, India
| | - Atul M Walimbe
- Bioinformatics Group, ICMR-National Institute of Virology, Pune, India
| | - Pradeep M Sawant
- Enteric Viruses Group, ICMR-National Institute of Virology, Pune, India
| | - Vijay R Kalrao
- Bharati Vidyapeeth Medical College and Hospital, Pune, India
| | - Ram K Dhongade
- Sant Dnyaneshwar Medical Foundation & Research Centre's Shaishav Clinic, Pune, India
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Philip AA, Patton JT. Rotavirus as an Expression Platform of Domains of the SARS-CoV-2 Spike Protein. Vaccines (Basel) 2021; 9:449. [PMID: 34063562 PMCID: PMC8147602 DOI: 10.3390/vaccines9050449] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 04/23/2021] [Accepted: 04/27/2021] [Indexed: 02/06/2023] Open
Abstract
Among vaccines administered to children are those targeting rotavirus, a segmented double-stranded RNA virus that represents a major cause of severe gastroenteritis. To explore the feasibility of establishing a combined rotavirus-SARS-CoV-2 vaccine, we generated recombinant (r)SA11 rotaviruses with modified segment 7 RNAs that contained coding cassettes for NSP3, a translational 2A stop-restart signal, and a FLAG-tagged portion of the SARS-CoV-2 spike (S) protein: S1 fragment, N-terminal domain (NTD), receptor-binding domain (RBD), extended RBD (ExRBD), or S2 core (CR) domain. Generation of rSA11 containing the S1 coding sequence required a sequence insertion of 2.2 kbp, the largest such insertion yet introduced into the rotavirus genome. Immunoblotting showed that rSA11 viruses containing the smaller NTD, RBD, ExRBD, and CR coding sequences expressed S-protein products of expected size, with ExRBD expressed at highest levels. These rSA11 viruses were genetically stable during serial passage. In contrast, the rSA11 virus containing the full-length S coding sequence (rSA11/NSP3-fS1) failed to express its expected 80 kDa fS1 product, for unexplained reasons. Moreover, rSA11/NSP3-fS1 was genetically unstable, with variants lacking the S1 insertion appearing during serial passage. Nonetheless, these results emphasize the potential usefulness of rotavirus vaccines as expression vectors of immunogenic portions of the SARS-CoV-2 S protein, including NTD, RBD, ExRBD, and CR, that have sizes smaller than the S1 fragment.
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41
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Burnett E, Parashar UD, Tate JE. Global Impact of Rotavirus Vaccination on Diarrhea Hospitalizations and Deaths Among Children <5 Years Old: 2006-2019. J Infect Dis 2021; 222:1731-1739. [PMID: 32095831 DOI: 10.1093/infdis/jiaa081] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 02/24/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Since 2006, more than 100 countries have introduced rotavirus vaccine into their immunization programs. We reviewed published data on relative reductions of rotavirus hospitalizations, acute gastroenteritis (AGE) hospitalizations, and AGE deaths among children <5 years old. METHODS Articles published from January 1, 2006 to December 31, 2019 with at least 12 months of data before and after rotavirus vaccine introduction were included. Relative reductions were abstracted into a standardized form. Descriptive statistics are presented as medians and interquartile ranges (IQRs). RESULTS We reviewed 1827 total records and included 105 articles from 49 countries. Among children <5 years old, there was a median reduction of 59% (IQR, 46-74) in rotavirus hospitalizations, 36% (IQR, 23-47) in AGE hospitalizations, and 36% (IQR, 28-46) AGE mortality. Reductions were larger in countries with low child mortality, among younger age groups, and in countries with higher coverage. The median percentage of specimens that tested positive for rotavirus among children <5 years old hospitalized for diarrhea was 40% (IQR, 28-45) before rotavirus vaccine introduction and 20% (IQR, 20-20) 4 years after introduction. CONCLUSIONS Overall, we found sustained impact on rotavirus and AGE hospitalizations and deaths. These results should encourage countries still considering rotavirus vaccine implementation.
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Affiliation(s)
- Eleanor Burnett
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Umesh D Parashar
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jacqueline E Tate
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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42
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Burke RM, Tate JE, Jiang B, Parashar UD. Rotavirus and Type 1 Diabetes-Is There a Connection? A Synthesis of the Evidence. J Infect Dis 2021; 222:1076-1083. [PMID: 32249284 DOI: 10.1093/infdis/jiaa168] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 04/02/2020] [Indexed: 12/26/2022] Open
Abstract
Although the etiology of type 1 diabetes (T1D) is not well understood, it is believed to comprise both genetic and environmental factors. Viruses are the most well studied environmental trigger, and there is a small but growing body of research on the potential influence of rotavirus on T1D. Rotavirus infections were initially identified as possible triggers of T1D given similarities between viral peptide sequences and T1D autoantigen peptide sequences. Furthermore, rotavirus infection has been shown to modify T1D risk in T1D-prone mice. However, research into associations of rotavirus infections with T1D development in humans have yielded mixed findings and suggested interactions with age and diet. As global availability of rotavirus vaccines increases, recent studies have assessed whether rotavirus vaccination modifies T1D development, finding null or protective associations. Overall, evidence to date suggests a possible triggering relationship between some wild-type rotavirus infections and T1D, but the potential effect of rotavirus vaccination remains unclear.
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Affiliation(s)
- Rachel M Burke
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jacqueline E Tate
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Baoming Jiang
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Umesh D Parashar
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Wang Y, Li J, Liu P, Zhu F. The performance of licensed rotavirus vaccines and the development of a new generation of rotavirus vaccines: a review. Hum Vaccin Immunother 2021; 17:880-896. [PMID: 32966134 DOI: 10.1080/21645515.2020.1801071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Rotavirus, which causes acute gastroenteritis and severe diarrhea, has posed a great threat to children worldwide over the last 30 y. Since no specific drugs and therapies against rotavirus are available, vaccination is considered the most effective method of decreasing the morbidity and mortality related to rotavirus-associated gastroenteritis. To date, six rotavirus vaccines have been developed and licensed by local governments. Notably, Rotarix™ and RotaTeq™ have been recommended as universal agents against rotavirus infection by the World Health Organization; however, lower efficacies were found in less-developed and developing regions with medium and high child mortality than well-developed ones with low child mortality. For now, two promising novel vaccines, Rotavac™ and RotaSiil™ were pre-qualified by the World Health Organization in 2018. Other rotavirus vaccines in the pipeline including neonatal strain (RV3-BB) and several non-replicating rotavirus vaccines with a parenteral delivery strategy are currently undergoing investigation, with the potential to improve the performance of, and eliminate the safety concerns associated with, previous live oral rotavirus vaccines. This paper reviews the important developments in rotavirus vaccines in the last 20 y and discusses problems and challenges that require investigation in the future.
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Affiliation(s)
- Yuxiao Wang
- School of Public Health, Southeast University, Nanjing, China
| | - Jingxin Li
- Vaccine Clinical Evaluation Department, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Pei Liu
- School of Public Health, Southeast University, Nanjing, China
| | - Fengcai Zhu
- Vaccine Clinical Evaluation Department, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
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Abstract
Rotavirus, a segmented double-stranded RNA virus, is a major cause of acute gastroenteritis in young children. The introduction of live oral rotavirus vaccines has reduced the incidence of rotavirus disease in many countries. To explore the possibility of establishing a combined rotavirus-SARS-CoV-2 vaccine, we generated recombinant (r)SA11 rotaviruses with modified segment 7 RNAs that contained coding sequences for NSP3 and FLAG-tagged portions of the SARS-CoV-2 spike (S) protein. A 2A translational element was used to drive separate expression of NSP3 and the S product. rSA11 viruses were recovered that encoded the S-protein S1 fragment, N-terminal domain (NTD), receptor-binding domain (RBD), extended receptor-binding domain (ExRBD), and S2 core (CR) domain (rSA11/NSP3-fS1, -fNTD, -fRBD, -fExRBD, and -fCR, respectively). Generation of rSA11/fS1 required a foreign-sequence insertion of 2.2-kbp, the largest such insertion yet made into the rotavirus genome. Based on isopycnic centrifugation, rSA11 containing S sequences were denser than wildtype virus, confirming the capacity of the rotavirus to accommodate larger genomes. Immunoblotting showed that rSA11/-fNTD, -fRBD, -fExRBD, and -fCR viruses expressed S products of expected size, with fExRBD expressed at highest levels. These rSA11 viruses were genetically stable during serial passage. In contrast, rSA11/NSP3-fS1 failed to express its expected 80-kDa fS1 product, for unexplained reasons. Moreover, rSA11/NSP3-fS1 was genetically unstable, with variants lacking the S1 insertion appearing during serial passage. Nonetheless, these results emphasize the potential usefulness of rotavirus vaccines as expression vectors of portions of the SARS-CoV-2 S protein (e.g., NTD, RBD, ExRBD, and CR) with sizes smaller than the S1 fragment.
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Affiliation(s)
- Asha A. Philip
- Department of Biology, Indiana University, Bloomington, IN 47405, USA
| | - John T. Patton
- Department of Biology, Indiana University, Bloomington, IN 47405, USA
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45
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Zeevat F, Dvortsin E, Wondimu A, Wilschut JC, Boersma C, Postma MJ. Rotavirus Vaccination of Infants Delayed and Limited within the National Immunization Programme in the Netherlands: An Opportunity Lost. Vaccines (Basel) 2021; 9:vaccines9020144. [PMID: 33579025 PMCID: PMC7916749 DOI: 10.3390/vaccines9020144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/03/2021] [Accepted: 02/05/2021] [Indexed: 12/24/2022] Open
Abstract
In this study, we estimated the benefits of rotavirus vaccination for infants had the rotavirus vaccine been introduced in the Netherlands as of its market authorization in 2006. An age-structured, deterministic cohort model was developed to simulate different birth cohorts over a period of 15 years from 2006 until 2021, comparing both universal and targeted high-risk group vaccination to no vaccination. Different scenarios for the duration of protection (5 or 7 years) and herd immunity (only for universal vaccination) were analyzed. All birth cohorts together included 2.6 million infants, of which 7.9% were high-risk individuals, and an additional 13.2 million children between 1-15 years born prior to the first cohort in 2006. The costs and health outcomes associated with rotavirus vaccination were calculated per model scenario and discounted at 4% and 1.5%, respectively. Our analysis reveals that, had rotavirus vaccination been implemented in 2006, it would have prevented 356,800 (51% decrease) and 32,200 (5% decrease) cases of rotavirus gastroenteritis after universal and targeted vaccination, respectively. Over the last 15 years, this would have led to significant avoided costs and quality-adjusted life year losses for either vaccination strategy with the most favorable outcomes for universal vaccination. Clearly, an opportunity has been lost.
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Affiliation(s)
- Florian Zeevat
- Department of Health Sciences, University Medical Centre, University of Groningen, 9713 AV Groningen, The Netherlands; (A.W.); (C.B.); (M.J.P.)
- Correspondence:
| | | | - Abrham Wondimu
- Department of Health Sciences, University Medical Centre, University of Groningen, 9713 AV Groningen, The Netherlands; (A.W.); (C.B.); (M.J.P.)
- Department of Pharmaceutics, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar P.O. Box 196, Ethiopia
| | - Jan C. Wilschut
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands;
| | - Cornelis Boersma
- Department of Health Sciences, University Medical Centre, University of Groningen, 9713 AV Groningen, The Netherlands; (A.W.); (C.B.); (M.J.P.)
- Faculty of Management Sciences, Open University, 6419 AT Heerlen, The Netherlands
| | - Maarten J. Postma
- Department of Health Sciences, University Medical Centre, University of Groningen, 9713 AV Groningen, The Netherlands; (A.W.); (C.B.); (M.J.P.)
- Department of Economics, Econometrics & Finance, University of Groningen, Faculty of Economics & Business, 9700 AV Groningen, The Netherlands
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Klivitsky A, Algabria S, Paret G, Michaan N, Goldberg L, Halutz O, Grisaru‐Soen G. Impact of rotavirus vaccine on admissions due to acute gastroenteritis and rotavirus gastroenteritis in Israel. Acta Paediatr 2021; 110:634-640. [PMID: 32654273 DOI: 10.1111/apa.15480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/21/2020] [Accepted: 07/09/2020] [Indexed: 11/27/2022]
Abstract
AIM We examined the impact of insertion of the Rotavirus vaccine (RVV) into the Israeli National Immunisation Programme (NIP) on hospitalisations due to both acute gastroenteritis (AGE) and Rotavirus gastroenteritis (RVGE) in children. METHODS We retrospectively analysed the medical records of children aged <5 years admitted with a diagnosis of AGE between 2008 and 2016 in two children's hospitals in central Israel. Clinical, laboratory, microbiological data and RV immunisation status were retrieved. Data were compared before and after the introduction of the RVV into the NIP. RESULTS A total of 2042 children were admitted with AGE. Hospitalisations due to AGE and RVGE decreased from 3310 to 1950 and from 1027 to 585 per 100 000 admissions, respectively, after the RVV (relative risk reduction (RRR) of 41% and 43%, respectively). RV remained the most common pathogen in both study periods. There was no significant difference in the clinical course between immunised and non-immunised children admitted with RVGE. CONCLUSION The introduction of the RVV to the NIP significantly reduced the admissions due to both AGE and RVGE in children <5 years. However, RV is still the most common agent for admissions due to AGE in this age group.
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Affiliation(s)
- Amir Klivitsky
- Pediatric Infectious Disease Unit Dana Children's Hospital Tel Aviv Israel
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| | - Salam Algabria
- Pediatric Infectious Disease Unit Dana Children's Hospital Tel Aviv Israel
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| | - Gideon Paret
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
- Department of Pediatric Intensive Care Sheba Medical Center Safra Children's Hospital Tel Hashomer Israel
| | - Nadav Michaan
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
- Department of Obstetrics and Gynecology Lis Maternity Hospital Tel Aviv Israel
| | - Lior Goldberg
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
- Department of Pediatric Intensive Care Sheba Medical Center Safra Children's Hospital Tel Hashomer Israel
| | - Ora Halutz
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
- Microbiology Laboratory Tel Aviv Sourasky Medical Center Tel Aviv Israel
| | - Galia Grisaru‐Soen
- Pediatric Infectious Disease Unit Dana Children's Hospital Tel Aviv Israel
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
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47
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Kim AH, Hogarty MP, Harris VC, Baldridge MT. The Complex Interactions Between Rotavirus and the Gut Microbiota. Front Cell Infect Microbiol 2021; 10:586751. [PMID: 33489932 PMCID: PMC7819889 DOI: 10.3389/fcimb.2020.586751] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 11/23/2020] [Indexed: 12/24/2022] Open
Abstract
Human rotavirus (HRV) is the leading worldwide cause of acute diarrhea-related death in children under the age of five. RV infects the small intestine, an important site of colonization by the microbiota, and studies over the past decade have begun to reveal a complex set of interactions between RV and the gut microbiota. RV infection can temporarily alter the composition of the gut microbiota and probiotic administration alleviates some symptoms of infection in vivo, suggesting reciprocal effects between the virus and the gut microbiota. While development of effective RV vaccines has offered significant protection against RV-associated mortality, vaccine effectiveness in low-income countries has been limited, potentially due to regional differences in the gut microbiota. In this mini review, we briefly detail research findings to date related to HRV vaccine cohorts, studies of natural infection, explorations of RV-microbiota interactions in gnotobiotic pig models, and highlight various in vivo and in vitro models that could be used in future studies to better define how the microbiota may regulate RV infection and host antiviral immune responses.
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Affiliation(s)
- Andrew HyoungJin Kim
- Department of Medicine, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, United States
| | - Michael P Hogarty
- Department of Medicine, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, United States
| | - Vanessa C Harris
- Department of Medicine, Division of Infectious Diseases and Department of Global Health (AIGHD), Amsterdam University Medical Center, Academic Medical Center, Amsterdam, Netherlands
| | - Megan T Baldridge
- Department of Medicine, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, United States
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48
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Otieno GP, Bottomley C, Khagayi S, Adetifa I, Ngama M, Omore R, Ogwel B, Owor BE, Bigogo G, Ochieng JB, Onyango C, Juma J, Mwenda J, Tabu C, Tate JE, Addo Y, Britton T, Parashar UD, Breiman RF, Verani JR, Nokes DJ. Impact of the Introduction of Rotavirus Vaccine on Hospital Admissions for Diarrhea Among Children in Kenya: A Controlled Interrupted Time-Series Analysis. Clin Infect Dis 2021; 70:2306-2313. [PMID: 31544211 PMCID: PMC7245159 DOI: 10.1093/cid/ciz912] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 09/12/2019] [Indexed: 01/10/2023] Open
Abstract
Background Monovalent rotavirus vaccine, Rotarix (GlaxoSmithKline), was introduced in Kenya in July 2014 and is recommended to infants as oral doses at ages 6 and 10 weeks. A multisite study was established in 2 population-based surveillance sites to evaluate vaccine impact on the incidence of rotavirus-associated hospitalizations (RVHs). Methods Hospital-based surveillance was conducted from January 2010 to June 2017 for acute diarrhea hospitalizations among children aged <5 years in 2 health facilities in Kenya. A controlled interrupted time-series analysis was undertaken to compare RVH pre– and post–vaccine introduction using rotavirus-negative cases as a control series. The change in incidence post–vaccine introduction was estimated from a negative binomial model that adjusted for secular trend, seasonality, and multiple health worker industrial actions (strikes). Results Between January 2010 and June 2017 there were 1513 and 1652 diarrhea hospitalizations in Kilifi and Siaya; among those tested for rotavirus, 28% (315/1142) and 23% (197/877) were positive, respectively. There was a 57% (95% confidence interval [CI], 8–80%) reduction in RVHs observed in the first year post–vaccine introduction in Kilifi and a 59% (95% CI, 20–79%) reduction in Siaya. In the second year, RVHs decreased further at both sites, 80% (95% CI, 46–93%) reduction in Kilifi and 82% reduction in Siaya (95% CI. 61–92%); this reduction was sustained at both sites into the third year. Conclusions A substantial reduction in RVHs and all-cause diarrhea was observed in 2 demographic surveillance sites in Kenya within 3 years of vaccine introduction.
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Affiliation(s)
- Grieven P Otieno
- Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Centre for Geographic Medicine Research-Coast, Kilifi, Kenya
| | | | - Sammy Khagayi
- KEMRI-Centre for Global Health Research, Kisumu, Kenya
| | - Ifedayo Adetifa
- Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Centre for Geographic Medicine Research-Coast, Kilifi, Kenya.,London School of Hygiene and Tropical Medicine, London, United Kingdom.,Department of Pediatrics and Child Health, College of Medicine University of Lagos, Lagos, Nigeria
| | - Mwanajuma Ngama
- Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Centre for Geographic Medicine Research-Coast, Kilifi, Kenya
| | - Richard Omore
- KEMRI-Centre for Global Health Research, Kisumu, Kenya
| | - Billy Ogwel
- KEMRI-Centre for Global Health Research, Kisumu, Kenya
| | - Betty E Owor
- Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Centre for Geographic Medicine Research-Coast, Kilifi, Kenya
| | | | | | - Clayton Onyango
- Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya
| | - Jane Juma
- KEMRI-Centre for Global Health Research, Kisumu, Kenya
| | - Jason Mwenda
- World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | | | - Jacqueline E Tate
- Centers for Disease Control and Prevention, Emory University, Atlanta, Georgia, USA
| | - Yaw Addo
- Emory Global Health Institute, Emory University, Atlanta, Georgia, USA
| | - Tuck Britton
- Emory Global Health Institute, Emory University, Atlanta, Georgia, USA
| | - Umesh D Parashar
- Centers for Disease Control and Prevention, Emory University, Atlanta, Georgia, USA
| | - Robert F Breiman
- Emory Global Health Institute, Emory University, Atlanta, Georgia, USA
| | | | - D James Nokes
- Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Centre for Geographic Medicine Research-Coast, Kilifi, Kenya.,School of Life Sciences and Zeeman Institute for Systems Biology and Infectious Disease Epidemiology Research, University of Warwick, Coventry, United Kingdom
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Xia M, Huang P, Jiang X, Tan M. A Nanoparticle-Based Trivalent Vaccine Targeting the Glycan Binding VP8* Domains of Rotaviruses. Viruses 2021; 13:72. [PMID: 33419150 PMCID: PMC7825513 DOI: 10.3390/v13010072] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/02/2021] [Accepted: 01/04/2021] [Indexed: 12/27/2022] Open
Abstract
Rotavirus causes severe gastroenteritis in children. Although vaccines are implemented, rotavirus-related diarrhea still claims ~200,000 lives annually worldwide, mainly in low-income settings, pointing to a need for improved vaccine tactics. To meet such a public health need, a P24-VP8* nanoparticle displaying the glycan-binding VP8* domains, the major neutralizing antigens of rotavirus, was generated as a new type of rotavirus vaccine. We reported here our development of a P24-VP8* nanoparticle-based trivalent vaccine. First, we established a method to produce tag-free P24-VP8* nanoparticles presenting the VP8*s of P[8], P[4], and P[6] rotaviruses, respectively, which are the three predominantly circulating rotavirus P types globally. This approach consists of a chemical-based protein precipitation and an ion exchange purification, which may be scaled up for large vaccine production. All three P24-VP8* nanoparticle types self-assembled efficiently with authentic VP8*-glycan receptor binding function. After they were mixed as a trivalent vaccine, we showed that intramuscular immunization of the vaccine elicited high IgG titers specific to the three homologous VP8* types in mice. The resulted mouse sera strongly neutralized replication of all three rotavirus P types in cell culture. Thus, the trivalent P24-VP8* nanoparticles are a promising vaccine candidate for parenteral use against multiple P types of predominant rotaviruses.
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Affiliation(s)
- Ming Xia
- Division of Infectious Diseases, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA; (M.X.); (P.H.)
| | - Pengwei Huang
- Division of Infectious Diseases, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA; (M.X.); (P.H.)
| | - Xi Jiang
- Division of Infectious Diseases, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA; (M.X.); (P.H.)
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA
| | - Ming Tan
- Division of Infectious Diseases, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA; (M.X.); (P.H.)
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA
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Groome MJ, Tate JE, Arnold M, Chitnis M, Cox S, de Vos C, Kirsten M, le Grange SM, Loveland J, Machaea S, Maharaj A, Andrews N, Madhi SA, Parashar UD. Evaluation of Intussusception After Oral Monovalent Rotavirus Vaccination in South Africa. Clin Infect Dis 2021; 70:1606-1612. [PMID: 31125061 PMCID: PMC7146001 DOI: 10.1093/cid/ciz431] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 05/22/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Postlicensure studies have shown an association between rotavirus vaccination and intussusception. We assessed the risk of intussusception associated with Rotarix (RV1) administration, at 6 and 14 weeks of age, in an upper-middle-income country, South Africa. METHODS Active prospective surveillance for intussusception was conducted in 8 hospitals from September 2013 through December 2017. Retrospective case enrollment was done at 1 hospital from July 2012 through August 2013. Demographic characteristics, symptom onset, and rotavirus vaccine status were ascertained. Using the self-controlled case-series method, we estimated age-adjusted incidence rate ratios within 1-7, 8-21, and 1-21 days of rotavirus vaccination in children aged 28-275 days at onset of symptoms. In addition, age-matched controls were enrolled for a subset of cases (n = 169), and a secondary analysis was performed. RESULTS Three hundred forty-six cases were included in the case-series analysis. Post-dose 1, there were zero intussusception cases within 1-7 days, and 5 cases within 8-21 days of vaccination. Post-dose 2, 15 cases occurred within 1-7 days, and 18 cases within 8-21 days of vaccination. There was no increased risk of intussusception 1-7 days after dose 1 (no cases observed) or dose 2 (relative incidence [RI], 1.71 [95% confidence interval {CI} .83-3.01]). Similarly, there was no increased risk 8-21 days after the first (RI, 4.01 [95% CI, .87-10.56]) or second dose (RI, .96 [95% CI, .52-1.60]). Results were similar for the case-control analysis. CONCLUSIONS The risk of intussusception in the 21 days after the first or second dose of RV1 was not higher than the background risk among South Africa infants. CLINICAL TRIALS REGISTRATION South African National Clinical Trial Register (DOH-27-0913-4183).
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Affiliation(s)
- Michelle J Groome
- Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences.,Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Marion Arnold
- Red Cross War Memorial Children's Hospital, University of Cape Town.,Tygerberg Hospital, University of Stellenbosch, Cape Town
| | | | - Sharon Cox
- Red Cross War Memorial Children's Hospital, University of Cape Town
| | - Corné de Vos
- Tygerberg Hospital, University of Stellenbosch, Cape Town
| | - Mari Kirsten
- Steve Biko Academic Hospital/Kalafong Hospital, University of Pretoria
| | | | - Jerome Loveland
- Chris Hani Baragwanath Academic Hospital/Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand, Johannesburg
| | - Sello Machaea
- East London Hospital Complex, Walter Sisulu University
| | - Ashwini Maharaj
- Inkosi Albert Luthuli Hospital, University of Kwa-Zulu Natal, Durban, South Africa
| | - Nick Andrews
- Statistics, Modelling and Economics Department, Public Health England, London, United Kingdom
| | - Shabir A Madhi
- Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences.,Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa
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