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五价轮状病毒疫苗 RV5 在最后一剂疫苗接种后长达 3.1 年内持续有效。

Sustained efficacy of the pentavalent rotavirus vaccine, RV5, up to 3.1 years following the last dose of vaccine.

机构信息

Vaccine Research Center, University of Tampere Medical School, Tampere, Finland.

出版信息

Pediatr Infect Dis J. 2010 Oct;29(10):957-63. doi: 10.1097/INF.0b013e3181e28e6e.

Abstract

BACKGROUND

Rotavirus gastroenteritis (RVGE) is a common cause of childhood hospitalizations and emergency department (ED) visits. In the Rotavirus Efficacy and Safety Trial (REST), the pentavalent rotavirus vaccine (RV5) significantly reduced RVGE-associated hospitalizations and ED visits for up to 2 years following the last vaccine dose. This study evaluated whether RV5 remained efficacious beyond 2 years.

METHODS

A total of 20,736 infants from Finland, initially in REST, were followed for RVGE-associated hospitalizations and ED visits in a Finnish extension study (FES) for up to 3.1 years after vaccination (age, ∼3.5 years).

RESULTS

The FES added >18,500 person-years and captured 150 RVGE-associated hospitalizations and ED visits (11 RV5; 139 placebo). In REST + FES, RV5 reduced RVGE-associated hospitalizations and ED visits, regardless of rotavirus serotype, by 94.0% (95% confidence interval [CI]: 91.4%-95.9%) for up to 3.1 years after vaccination. RV5 also conferred significant protection against hospitalizations and ED visits associated with rotavirus serotypes G1 (95.5%; 95% CI: 92.8%-97.2%), G2 (81.9%; 95% CI: 16.1%-98.0%), G3 (89.0%; 95% CI: 53.3%-98.7%), G4 (83.4%; 95% CI: 51.2%-95.8%), and G9 (94.2%; 95% CI: 62.2%-99.9%). Rate reductions (95% CI) in hospitalizations and ED visits during the first, second, and third years of life were 94.0% (90.0%-96.5%), 94.7% (90.7%-97.2%), and 85.9% (51.6%-97.2%), respectively.

CONCLUSIONS

RVGE-associated hospitalizations and ED visits remain common in the second year of life but decrease in the third year of life. RV5 showed sustained protective efficacy against RVGE-associated hospitalizations and ED visits, regardless of rotavirus serotype, for up to 3.1 years after vaccination.

摘要

背景

轮状病毒胃肠炎(RVGE)是导致儿童住院和急诊就诊的常见原因。在轮状病毒效力和安全性试验(REST)中,五价轮状病毒疫苗(RV5)在最后一剂疫苗接种后长达 2 年内显著降低了 RVGE 相关的住院和急诊就诊率。本研究评估了 RV5 在 2 年以上是否仍然有效。

方法

来自芬兰的 20736 名婴儿最初参加了 REST,在疫苗接种后长达 3.1 年的芬兰扩展研究(FES)中,他们因 RVGE 相关住院和急诊就诊而接受了随访(年龄约为 3.5 岁)。

结果

FES 增加了超过 18500 人年,并捕获了 150 例 RVGE 相关住院和急诊就诊病例(11 例 RV5;139 例安慰剂)。在 REST+FES 中,RV5 降低了 RVGE 相关住院和急诊就诊,无论轮状病毒血清型如何,在疫苗接种后长达 3.1 年的时间内,其有效性为 94.0%(95%置信区间[CI]:91.4%-95.9%)。RV5 还对 G1(95.5%;95%CI:92.8%-97.2%)、G2(81.9%;95%CI:16.1%-98.0%)、G3(89.0%;95%CI:53.3%-98.7%)、G4(83.4%;95%CI:51.2%-95.8%)和 G9(94.2%;95%CI:62.2%-99.9%)血清型的 RVGE 相关住院和急诊就诊也具有显著的保护作用。在生命的第一年、第二年和第三年,住院和急诊就诊的发生率分别降低了 94.0%(90.0%-96.5%)、94.7%(90.7%-97.2%)和 85.9%(51.6%-97.2%)。

结论

在生命的第二年,RVGE 相关住院和急诊就诊仍然很常见,但在生命的第三年则减少。RV5 对 RVGE 相关住院和急诊就诊的保护作用持续存在,无论轮状病毒血清型如何,在疫苗接种后长达 3.1 年的时间内均有效。

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