British Medical Journal
01 September 2012 (Vol 345, Issue 7872)
Effectiveness of rotavirus vaccination in prevention of hospital admissions for rotavirus gastroenteritis among young children in Belgium: case-control study
Tessa Braeckman, predoctoral researcher1, Koen Van Herck, senior lecturer in vaccinology and public health12, Nadia Meyer, epidemiology director3, Jean-Yves Pirçon, study biostatistician3, Montse Soriano-Gabarró, head of global epidemiology4, Elisabeth Heylen, predoctoral researcher5, Mark Zeller, predoctoral researcher5, Myriam Azou, paediatrician6, Heidi Capiau, paediatrician7, Jan De Koster, paediatrician8, Anne-Sophie Maernoudt, paediatrician9, Marc Raes, paediatrician10, Lutgard Verdonck, paediatrician11, Marc Verghote, paediatrician12, Anne Vergison, paediatrician13, Jelle Matthijnssens, postdoctoral researcher5, Marc Van Ranst, professor faculty of medicine5, Pierre Van Damme, professor faculty of medicine1 on behalf of the RotaBel Study Group
Objective To evaluate the effectiveness of rotavirus vaccination among young children in Belgium.
Design Prospective case-control study.
Setting Random sample of 39 Belgian hospitals, February 2008 to June 2010.
Participants 215 children admitted to hospital with rotavirus gastroenteritis confirmed by polymerase chain reaction and 276 age and hospital matched controls. All children were of an eligible age to have received rotavirus vaccination (that is, born after 1 October 2006 and aged ≥14 weeks).
Main outcome measure Vaccination status of children admitted to hospital with rotavirus gastroenteritis and matched controls.
Results 99 children (48%) admitted with rotavirus gastroenteritis and 244 (91%) controls had received at least one dose of any rotavirus vaccine (P<0.001). The monovalent rotavirus vaccine accounted for 92% (n=594) of all rotavirus vaccine doses. With hospital admission as the outcome, the unadjusted effectiveness of two doses of the monovalent rotavirus vaccine was 90% (95% confidence interval 81% to 95%) overall, 91% (75% to 97%) in children aged 3-11 months, and 90% (76% to 96%) in those aged ≥12 months. The G2P genotype accounted for 52% of cases confirmed by polymerase chain reaction with eligible matched controls. Vaccine effectiveness was 85% (64% to 94%) against G2P and 95% (78% to 99%) against G1P. In 25% of cases confirmed by polymerase chain reaction with eligible matched controls, there was reported co-infection with adenovirus, astrovirus and/or norovirus. Vaccine effectiveness against co-infected cases was 86% (52% to 96%). Effectiveness of at least one dose of any rotavirus vaccine (intention to vaccinate analysis) was 91% (82% to 95%).
Conclusions Rotavirus vaccination is effective for the prevention of admission to hospital for rotavirus gastroenteritis among young children in Belgium, despite the high prevalence of G2P and viral co-infection.