Immergluck Lilly Cheng, Parker Trisha Chan, Jain Shabnam, Laghaie Elham, Spandorfer Philip, Jerris Robert C, Bowen Michael D, Parashar Umesh D, Cortese Margaret M
Departments of Microbiology, Biochemistry, Immunology, and Pediatrics, Morehouse School of Medicine, Atlanta, GA; Clinical Research Center, Morehouse School of Medicine, Atlanta, GA; Children's Healthcare of Atlanta, Atlanta, GA.
Departments of Microbiology, Biochemistry, Immunology, and Pediatrics, Morehouse School of Medicine, Atlanta, GA; Clinical Research Center, Morehouse School of Medicine, Atlanta, GA.
J Pediatr. 2016 May;172:116-120.e1. doi: 10.1016/j.jpeds.2016.01.042. Epub 2016 Feb 28.
Using case-control methodology, we measured the vaccine effectiveness (VE) of the 2-dose monovalent rotavirus vaccine (RV1) and 3-dose pentavalent rotavirus vaccine (RV5) series given in infancy against rotavirus disease resulting in hospital emergency department or inpatient care.
Children were eligible for enrollment if they presented to any 1 of 3 hospitals in Atlanta, Georgia with diarrhea ≤10 days duration during January-June 2013 and were born after RV1 introduction. Stool samples were tested for rotavirus by enzyme immunoassay and immunization records were obtained from providers and the state electronic immunization information system. Case-subjects (children testing rotavirus antigen-positive) were compared with children testing rotavirus antigen-negative.
Overall, 98 rotavirus-case subjects and 175 rotavirus-negative controls were enrolled. Genotype G12P[8] predominated (n = 87, 89%). The VE of 2 RV1 doses was 84% (95% CI 38, 96) among children aged 8-23 months and 82% (95% CI 41, 95) among children aged ≥24 months. For the same age groups, the VE of 3 RV5 doses was 80% (95% CI 27, 95) and 87% (95% CI 22, 98), respectively.
Under routine use, the RV1 and RV5 series were both effective against moderate-to-severe rotavirus disease during a G12P[8] season, and both vaccines demonstrated sustained protection beyond the first 2 years of life.
采用病例对照研究方法,我们测定了婴儿期接种的2剂单价轮状病毒疫苗(RV1)和3剂五价轮状病毒疫苗(RV5)系列针对导致医院急诊科就诊或住院治疗的轮状病毒疾病的疫苗效力(VE)。
2013年1月至6月期间,在佐治亚州亚特兰大市3家医院中的任何一家出现腹泻持续时间≤10天且在RV1引入后出生的儿童符合纳入标准。通过酶免疫测定法对粪便样本进行轮状病毒检测,并从医疗机构和州电子免疫信息系统获取免疫记录。将病例组(轮状病毒抗原检测呈阳性的儿童)与轮状病毒抗原检测呈阴性的儿童进行比较。
总体而言,共纳入98例轮状病毒病例组儿童和175例轮状病毒阴性对照组儿童。G12P[8]基因型占主导(n = 87,89%)。2剂RV1在8至23个月龄儿童中的疫苗效力为84%(95%CI 38,96),在≥24个月龄儿童中的疫苗效力为82%(95%CI 41,95)。对于相同年龄组,3剂RV5的疫苗效力分别为80%(95%CI 27,95)和87%(95%CI 22,98)。
在常规使用情况下,RV1和RV5系列在G12P[8]流行季节均对中重度轮状病毒疾病有效,且两种疫苗在生命的前2年之后都显示出持续的保护作用。