Fujita Health University Hospital, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan.
GSK, 1-8-1 Akasaka, Minato-ku, Tokyo 107-0052, Japan.
Vaccine. 2018 Jan 25;36(4):527-534. doi: 10.1016/j.vaccine.2017.12.006. Epub 2017 Dec 13.
In Nagoya city, Japan, rotavirus (RV) vaccination has been available since 2011 with estimated coverage reaching 92% by 2015 after the introduction of a public subsidy in 2012. This study assessed the impact of vaccination on the RV gastroenteritis (RVGE) burden in children aged <5 years old (y) by comparing RVGE hospitalizations and outpatient visits during pre-vaccination (2007-2011), transition (2011-2012) and subsidization (2012-2016) periods.
All hospitalizations and outpatient visits in children aged <5 y from 2 administrative districts of Nagoya city were identified from the hospital-based electronic databases of 4 hospitals. RVGE cases were identified by diagnostic code and/or positive results of diagnostic kits.
Compared to the pre-vaccination period, there was a decrease in RVGE hospitalizations for children <5 y from 5.59 per 1000 person-year (kPY) to 3.65/kPY in the subsidization period (i.e. 34.69%). In children <1 y, the incidence of RVGE hospitalizations decreased continuously from 6.62/kPY in the pre-vaccination period to 1.84/kPY in the subsidization period (i.e. 72.19%). The highest decrease was observed in the subsidization season i.e. when high coverage was reached: 69% and 75.57% in the 2013/2014 season for 2-3 y and 3-4 y, and 74.03% in the 2014/2015 season for 4-5 y, respectively. Proportion of RVGE outpatient visits decreased by 87.44% for children <1 y and 57.05% for <5 y from the pre-vaccination to the subsidization period. This decrease started the first year of subsidization for children <1 y, 1-2 y and 2-3 y (78.89%, 18.86% and 5.80%) and the second year (2013/2014 season) for children 3-4 y and 4-5 y (87.73% and 51.78%).
Although yearly fluctuations have been observed, the introduction of vaccination significantly decreased pediatric RVGE hospitalizations and outpatient visits, especially in the age group eligible for vaccination. During the second and third year of subsidization, we observed a herd protection effect on other age groups <5 y who were not eligible for vaccination. Clinicaltrial.gov.registered#:NCT01733862.
在日本名古屋市，自 2011 年以来，轮状病毒（RV）疫苗接种已经可用，2012 年推出公共补贴后，到 2015 年估计覆盖率达到 92%。本研究通过比较接种前（2007-2011 年）、过渡期（2011-2012 年）和补贴期（2012-2016 年）的 RV 胃肠炎（RVGE）住院和门诊就诊情况，评估了接种对<5 岁儿童 RVGE 负担的影响。
从名古屋市 2 个行政区的 4 家医院的基于医院的电子数据库中确定了<5 岁儿童的所有住院和门诊就诊。通过诊断代码和/或诊断试剂盒的阳性结果确定 RVGE 病例。
与接种前相比，补贴期<5 岁儿童的 RVGE 住院率从每 1000 人年 5.59 例降至 3.65/人年（即 34.69%）。在<1 岁儿童中，RVGE 住院率从接种前的 6.62/人年持续下降至补贴期的 1.84/人年（即 72.19%）。在补贴季节，即高覆盖率时，下降幅度最大：2013/2014 季节，2-3 岁和 3-4 岁儿童分别下降 69%和 75.57%，2014/2015 季节，4-5 岁儿童下降 74.03%。接种前至补贴期，<1 岁儿童的 RVGE 门诊就诊比例下降 87.44%，<5 岁儿童下降 57.05%。<1 岁儿童的下降始于补贴的第一年，1-2 岁和 2-3 岁（78.89%、18.86%和 5.80%）以及第二年（2013/2014 季节）的 3-4 岁和 4-5 岁（87.73%和 51.78%）。
尽管出现了年度波动，但疫苗接种的引入显著降低了儿科 RVGE 的住院和门诊就诊率，特别是在有资格接种疫苗的年龄组。在补贴的第二年和第三年，我们观察到对其他未接种疫苗的<5 岁年龄组产生了群体保护效应。Clinicaltrial.gov.registered#：NCT01733862。
