Yeung Karene Hoi Ting, Tate Jacqueline E, Chan Ching Ching, Chan Martin C W, Chan Paul K S, Poon Kin Hung, Siu Sylvia Luen Yee, Fung Genevieve Po Gee, Ng Kwok Leung, Chan Iris Mei Ching, Yu Pui Tak, Ng Chi Hang, Lau Yu Lung, Nelson E Anthony S
Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
Epidemiology Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, USA.
Vaccine. 2016 Sep 22;34(41):4935-4942. doi: 10.1016/j.vaccine.2016.08.047. Epub 2016 Aug 29.
Rotavirus is a common infectious cause of childhood hospitalisation in Hong Kong. Rotavirus vaccines have been used in the private sector since licensure in 2006 but have not been incorporated in the government's universal Childhood Immunisation Programme. This study aimed to evaluate rotavirus vaccine effectiveness against hospitalisation.
This case-control study was conducted in the 2014/2015 rotavirus season in six public hospitals. Hospitalised acute gastroenteritis patients meeting inclusion criteria were recruited and copies of their immunisation records were collected. Case-patients were defined as enrolled subjects with stool specimens obtained in the first 48h of hospitalisation that tested positive for rotavirus, whereas control-patients were those with stool specimens obtained in the first 48h of hospitalisation testing negative for rotavirus. Vaccine effectiveness for administration of at least one dose of either Rotarix(®) (GlaxoSmithKline Biologicals) or RotaTeq(®) (Merck Research Laboratories) was calculated as 1 minus the odds ratio for rotavirus vaccination history for case-patients versus control-patients.
Among the 525 eligible subjects recruited, immunisation records were seen in 404 (77%) subjects. 31% (162/525 and 126/404) tested positive for rotavirus. In the 404 subjects assessed for vaccine effectiveness, 2.4% and 24% received at least 1 dose of either rotavirus vaccine in case- and control-patients respectively. The unmatched vaccine effectiveness against hospitalisation for administration of at least one dose of either rotavirus vaccines was 92% (95% confidence interval [CI]: 75%, 98%). The matched analyses by age only and both age and admission date showed 96% (95% CI: 72%, 100%) and 89% (95% CI: 51%, 97%) protection against rotavirus hospitalisation respectively.
Rotavirus vaccine is highly effective in preventing hospitalisation from rotavirus disease in young Hong Kong children.
轮状病毒是香港儿童住院常见的感染病因。自2006年获批以来，轮状病毒疫苗已在私立部门使用，但尚未纳入政府的儿童常规免疫计划。本研究旨在评估轮状病毒疫苗预防住院的效果。
本病例对照研究于2014/2015年轮状病毒流行季在6家公立医院开展。招募符合纳入标准的住院急性胃肠炎患者，并收集其免疫记录副本。病例患者定义为住院首48小时内采集的粪便标本轮状病毒检测呈阳性的入组受试者，而对照患者为住院首48小时内采集的粪便标本轮状病毒检测呈阴性的受试者。至少接种一剂罗特威（Rotarix，®葛兰素史克生物制品公司）或瑞必威（RotaTeq，®默克研究实验室）疫苗的疫苗效力计算为1减去病例患者与对照患者轮状病毒疫苗接种史的比值比。
在招募的525名符合条件的受试者中，404名（77%）有免疫记录。31%（162/525和126/404）的受试者轮状病毒检测呈阳性。在评估疫苗效力的404名受试者中，病例患者和对照患者分别有2.4%和24%至少接种一剂轮状病毒疫苗。至少接种一剂两种轮状病毒疫苗预防住院的未匹配疫苗效力为92%（95%置信区间[CI]：75%，98%）。仅按年龄以及按年龄和入院日期进行匹配分析，预防轮状病毒住院的保护率分别为96%（95%CI：72%，100%）和89%（95%CI：51%，97%）。
轮状病毒疫苗在预防香港幼儿因轮状病毒疾病住院方面非常有效。
