Uhlig Ulrike, Kostev Karel, Schuster Volker, Koletzko Sibylle, Uhlig Holm H
From the *Department of Pediatrics, John Radcliffe Hospital, Oxford, United Kingdom; †University Hospital for Children and Adolescents, Martin Luther University, Halle; ‡Institute of Medical Statistics, Frankfurt/Main; §University Hospital for Children and Adolescents, University of Leipzig, Leipzig; ¶Dr von Hauner Children's Hospital, Ludwig Maximilian University of Munich, Munich, Germany; and ‖Translational Gastroenterology Unit, University of Oxford, Oxford, United Kingdom.
Pediatr Infect Dis J. 2014 Nov;33(11):e299-304. doi: 10.1097/INF.0000000000000441.
Although rotavirus (RV) vaccination was licensed in 2006, it was not included into the officially recommended German childhood vaccination schedule until 2013. Local differences in health policies in the past led to large differences in vaccination coverage rate among the federal states of Germany. This enables an ecologic study of RV vaccine effectiveness.
We performed a population-based retrospective analysis of RV vaccination use, RV notification and hospitalization among 0 to 5-year-old children in Germany during 2006 to 2011/2012. We compared effectiveness of the 2 RV vaccines, Rotateq and Rotarix, in an ambulatory setting and analyzed potential side effects.
We observed a significant reduction in RV notifications since introduction of RV vaccination. In areas attaining vaccine coverage of 64%, RV-related hospital admissions of 0 and 1-year-old children decreased by 60% compared with 19% reduction in the low vaccination coverage area. Decrease in RV-related hospitalizations of 0 and 1-year-old children was specific and significantly associated with vaccination coverage of the individual federal state (P < 0.0001, r = -0.68). There was no overall increase in intussusception rate or Kawasaki disease-related hospital admissions since introduction of RV vaccination. The 2 licensed RV vaccines had similar effectiveness in the ambulatory setting.
Postmarketing data suggest that RV vaccination is efficient in reducing RV-related hospitalizations. There is no apparent difference in effectiveness for Rotarix and Rotateq.
尽管轮状病毒（RV）疫苗于2006年获得许可，但直到2013年才被纳入德国官方推荐的儿童疫苗接种计划。过去地方卫生政策的差异导致德国联邦州之间的疫苗接种覆盖率存在很大差异。这使得能够对RV疫苗的有效性进行生态学研究。
我们对2006年至2011/2012年期间德国0至5岁儿童的RV疫苗接种使用情况、RV报告和住院情况进行了基于人群的回顾性分析。我们比较了两种RV疫苗Rotateq和Rotarix在门诊环境中的有效性，并分析了潜在的副作用。
自引入RV疫苗接种以来，我们观察到RV报告显著减少。在疫苗接种覆盖率达到64%的地区，0岁和1岁儿童与RV相关的住院人数减少了60%，而在低疫苗接种覆盖率地区减少了19%。0岁和1岁儿童与RV相关的住院人数减少是特异性的，并且与各个联邦州的疫苗接种覆盖率显著相关（P < 0.0001，r = -0.68）。自引入RV疫苗接种以来，肠套叠发生率或川崎病相关住院人数没有总体增加。两种获得许可的RV疫苗在门诊环境中的有效性相似。
上市后数据表明，RV疫苗接种在减少与RV相关的住院方面是有效的。Rotarix和Rotateq在有效性方面没有明显差异。
