Baylor College of Medicine, Center for Vaccine Awareness and Research, Texas Children's Hospital, 6701 Fannin St, CC1540, Houston, TX 77030, USA.
Pediatrics. 2010 Feb;125(2):e199-207. doi: 10.1542/peds.2009-1021. Epub 2010 Jan 18.
The goal was to assess the effectiveness of complete (3-dose) or partial (1- or 2-dose) immunization with pentavalent rotavirus vaccine (RV5) against rotavirus acute gastroenteritis (AGE) in US clinical practice.
A case-control evaluation was conducted in February through June 2008 at an emergency department in Houston, Texas. Case patients with rotavirus AGE (N = 90) were identified through testing for rotavirus in fecal specimens obtained from 205 children 15 days through 23 months of age presenting with AGE. Control groups included rotavirus-negative AGE patients (N = 115), concurrently enrolled patients with acute respiratory infection (ARI) (N = 228), and up to 10 age- and zip code-matched children sampled from the Houston-Harris County Immunization Registry (HHCIR) for each case patient >8 months of age. Immunization data were obtained from parent records, health care providers, and/or the HHCIR. Vaccine effectiveness was calculated as 1 minus odds of RV5 vaccination for case patients versus control patients, after adjustment for age at presentation and birth date.
The vaccine effectiveness of a complete RV5 series was 89% (95% confidence interval [CI]: 70%-96%) and 85% (95% CI: 55%-95%) with rotavirus-negative AGE and ARI control patients, respectively. Immunization data were available for 44% of case patients (n = 40) from the HHCIR; the estimated 3-dose vaccine effectiveness with these HHCIR control patients was 82% (95% CI: 19%-96%). A complete RV5 series conferred 100% protection (95% CI: 71%-100%) against severe rotavirus disease requiring hospitalization and 96% protection (95% CI: 72%-99%) against disease requiring intravenous hydration. Vaccine effectiveness of 1 and 2 doses against hospitalization and emergency department visits was 69% (95% CI: 13%-89%) and 81% (95% CI: 13%-96%), respectively, using rotavirus-negative AGE and ARI control groups combined.
In this setting, a complete series of RV5 was highly effective against severe rotavirus AGE. Partial immunization also conferred substantial protection.
评估五价轮状病毒疫苗（RV5）完全免疫（3 剂）或部分免疫（1 剂或 2 剂）对美国临床实践中轮状病毒急性胃肠炎（AGE）的效果。
2008 年 2 月至 6 月在德克萨斯州休斯顿的一家急诊室进行了病例对照评估。通过对 205 名 15 天至 23 个月龄出现 AGE 的儿童粪便样本中轮状病毒的检测，确定轮状病毒 AGE 病例患者（N=90）。对照组包括轮状病毒阴性 AGE 患者（N=115）、同期急性呼吸道感染（ARI）患者（N=228），以及每个大于 8 个月龄的病例患者从休斯顿-哈里斯县免疫登记处（HHCIR）中匹配年龄和邮政编码的最多 10 名儿童。免疫接种数据来自父母记录、医疗保健提供者和/或 HHCIR。疫苗效力的计算方法为病例患者与对照患者 RV5 疫苗接种率的差值，调整了就诊时的年龄和出生日期。
完全 RV5 系列疫苗的效力分别为 89%（95%置信区间[CI]：70%-96%）和 85%（95% CI：55%-95%），针对轮状病毒阴性 AGE 和 ARI 对照患者。HHCIR 中有 44%的病例患者（n=40）可获得免疫接种数据；使用这些 HHCIR 对照患者的 3 剂疫苗效力估计为 82%（95% CI：19%-96%）。完全 RV5 系列疫苗对需要住院治疗的严重轮状病毒疾病提供 100%的保护（95% CI：71%-100%），对需要静脉补液治疗的疾病提供 96%的保护（95% CI：72%-99%）。1 剂和 2 剂疫苗对住院和急诊就诊的效力分别为 69%（95% CI：13%-89%）和 81%（95% CI：13%-96%），使用轮状病毒阴性 AGE 和 ARI 对照组合并。
在这种情况下，RV5 的完全系列对严重轮状病毒 AGE 非常有效。部分免疫也提供了实质性的保护。
