Tharmaphornpilas Piyanit, Jiamsiri Suchada, Boonchaiya Somchit, Rochanathimoke Onwipa, Thinyounyong Wiravan, Tuntiwitayapun Sumana, Guntapong Ratigorn, Riewpaiboon Arthorn, Rasdjarmrearnsook Aim-On, Glass Roger I
Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand.
Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand.
Vaccine. 2017 Feb 1;35(5):796-801. doi: 10.1016/j.vaccine.2016.12.043. Epub 2017 Jan 2.
We assessed the effectiveness and possible impact of introducing rotavirus vaccine into the routine immunization program.
Two provinces were selected for an observational study, one where vaccine was introduced and another where vaccine was not available. In these areas, two sub-studies were linked. The prospective cohort study enrolled children 2month old and followed them to the age of 18months to detect all diarrhea episodes. The hospital surveillance study enrolled all children up to age 5 hospitalized with diarrhea whose fecal samples were tested for rotavirus. Rates of rotavirus hospitalizations in older children who had not been vaccinated in both settings provided data to determine whether immunization had an indirect herd effect. The key endpoints for the study were both vaccine effectiveness (VE) based upon hospitalized rotavirus diarrhea and herd protection.
From the cohort study, the overall VE for hospitalized rotavirus diarrhea was 88% (95%CI 76-94). Data from hospital surveillance indicated that for 2 consecutive years, the seasonal peak of rotavirus admissions was no longer present in the vaccinated area. Herd protection was observed among older children born before the rotavirus vaccine program was introduced, who experienced a 40-69% reduction in admission for rotavirus.
Rotavirus vaccine was highly effective in preventing diarrheal hospitalizations and in conferring herd protection among older children who had not been vaccinated.
我们评估了将轮状病毒疫苗引入常规免疫规划的有效性及可能产生的影响。
选择两个省份进行观察性研究，一个引入了疫苗，另一个未引入疫苗。在这些地区，两项子研究相互关联。前瞻性队列研究纳入2月龄儿童并随访至18月龄，以检测所有腹泻发作情况。医院监测研究纳入所有5岁以下因腹泻住院且粪便样本接受轮状病毒检测的儿童。在这两种情况下，未接种疫苗的大龄儿童的轮状病毒住院率提供了数据，以确定免疫接种是否具有间接群体效应。该研究的关键终点是基于住院轮状病毒腹泻的疫苗效力（VE）和群体保护。
队列研究显示，住院轮状病毒腹泻的总体疫苗效力为88%（95%CI 76 - 94）。医院监测数据表明，连续两年，接种疫苗地区不再出现轮状病毒入院的季节性高峰。在轮状病毒疫苗计划实施前出生的大龄儿童中观察到了群体保护作用，他们因轮状病毒入院的比例降低了40% - 69%。
轮状病毒疫苗在预防腹泻住院以及为未接种疫苗的大龄儿童提供群体保护方面非常有效。
