Vesikari Timo, Uhari Matti, Renko Marjo, Hemming Maria, Salminen Marjo, Torcel-Pagnon Laurence, Bricout Hélène, Simondon François
From the *Vaccine Research Centre, University of Tampere Medical School, Tampere; †Department of Paediatrics, University of Oulu, Oulu, Finland; and ‡Epidemiology Department, Sanofi Pasteur MSD, Lyon, France.
Pediatr Infect Dis J. 2013 Dec;32(12):1365-73. doi: 10.1097/INF.0000000000000086.
Finland introduced universal rotavirus (RV) vaccination in September 2009, with exclusive use of the pentavalent human-bovine reassortant RV vaccine RotaTeq® and following a vaccination schedule at 2, 3 and 5 months of age. This study monitored the impact of RV vaccination on hospitalizations due to RV acute gastroenteritis (RVGE). The results following the first 3 RV seasons after implementation of universal RV vaccination are presented.
Prospective hospital-based surveillance identified children with acute gastroenteritis admitted to 2 University Hospitals (Tampere and Oulu, Finland), from December 2009 to August 2012. The surveillance covered a population of approximately 173,000 children from the 2 hospitals' catchment areas. Stool samples were taken and analyzed centrally for RV by enzyme-linked immunosorbent assay, with genotyping by reverse transcription polymerase chain reaction. International Classification of Diseases discharge codes were collected retrospectively pre- and postvaccination.
During the 3-year prospective surveillance, 127 RVGE episodes were identified. Of these, 117 were in unvaccinated children and 6 were in fully vaccinated children (RotaTeq, n = 3; Rotarix, n = 3). The vaccine effectiveness against hospitalized RVGE for fully vaccinated children was 92.1% [95% confidence interval (CI): 50.0-98.7] among children eligible for the National Immunization Program. When analyzing retrospectively the Tampere and Oulu hospital databases for all children aged <16 years, hospitalizations for RVGE had decreased by 78% in the postvaccination period (2009-2012) compared with the prevaccination data (2001-2006).
Severe RVGE requiring hospitalization was virtually eliminated in vaccine-eligible children in the 3 years following implementation of universal RotaTeq vaccination in Finland.
芬兰于2009年9月引入了轮状病毒（RV）普遍接种计划，独家使用五价人-牛重配RV疫苗Rotateq®，并按照2、3和5月龄的接种程序进行接种。本研究监测了RV接种对RV急性胃肠炎（RVGE）住院率的影响。本文呈现了普遍RV接种实施后头3个RV流行季的结果。
基于医院的前瞻性监测确定了2009年12月至2012年8月期间入住2所大学医院（芬兰坦佩雷和奥卢）的急性胃肠炎儿童。监测覆盖了来自这2所医院服务区域的约173,000名儿童。采集粪便样本并集中通过酶联免疫吸附测定法分析RV，通过逆转录聚合酶链反应进行基因分型。回顾性收集接种前后的国际疾病分类出院编码。
在3年的前瞻性监测期间，共确定了127例RVGE发作。其中，117例发生在未接种疫苗的儿童中，6例发生在完全接种疫苗的儿童中（Rotateq，n = 3；Rotarix，n = 3）。在符合国家免疫计划的儿童中，完全接种疫苗的儿童针对住院RVGE的疫苗效力为92.1% [95%置信区间（CI）：50.0 - 98.7]。回顾性分析坦佩雷和奥卢医院所有16岁以下儿童的数据库时，与接种前数据（2001 - 2006年）相比，接种后时期（2009 - 2012年）RVGE住院率下降了78%。
在芬兰实施普遍Rotateq接种后的3年里，符合疫苗接种条件的儿童中几乎消除了需要住院治疗的严重RVGE。
