Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI), Inserm, UVSQ, Institut Pasteur, Université Paris-Saclay, Villejuif, France.
Centre de Recherche en Epidémiologie et Santé des Population (CESP), Inserm, Villejuif, France.
Euro Surveill. 2017 Dec;22(50). doi: 10.2807/1560-7917.ES.2017.22.50.17-00041.
IntroductionTwo vaccines available for protection against rotavirus gastroenteritis (RVGE), Rotarix and RotaTeq, have contributed to a large decrease in the incidence of paediatric diarrhoea in countries where they have been used. However, they have also led to a small increase in the risk of intussusception. We compare the number of prevented hospitalisations for RVGE to the number of vaccine-induced hospitalised intussusceptions in France. With 9.5% coverage (French 2015 estimation), vaccination was estimated to prevent, annually, a median of 1,074 hospitalisations (2.5th and 97.5th percentiles (2.5th-97.5th): 810-1,378) and 1.4 deaths (2.5th-97.5th: 1.2-1.6) from RVGE. It was also estimated to cause, annually, 5.0 hospitalisations (2.5th-97.5th: 3.2-7.7) and 0.005 deaths (2.5th-97.5th: 0.001-0.015) from intussusception. The benefit-risk ratio is therefore 214 (2.5th-97.5th: 128-362) for hospitalisations and 273 (2.5th-97.5th: 89-1,228) for deaths. Under a hypothetical 92% coverage, rotavirus vaccination with Rotarix would avoid 10,459 (2.5th-97.5th: 7,702-13,498) hospitalisations for RVGE and induce 47.0 (2.5th-97.5th: 25.1-81.4) hospitalisations for intussusception annually, thereby preventing 13.7 (2.5th-97.5th: 11.1-15.2) deaths and inducing 0.05 (2.5th-97.5th: 0.01-0.15) deaths. The benefit-risk ratio in France is similar to that of other European countries.
引言
两种轮状病毒疫苗（Rotarix 和 RotaTeq）可预防轮状病毒胃肠炎（RVGE），在使用这些疫苗的国家，它们大大降低了儿科腹泻的发病率。然而，它们也导致了肠套叠住院风险的小幅度增加。我们比较了法国因 RVGE 而预防住院的人数与疫苗引起的肠套叠住院人数。
接种率为 9.5%（法国 2015 年的估计值），每年疫苗接种估计可预防 RVGE 住院的中位数为 1074 例（25%分位数至 97.5%分位数：810-1378）和 1.4 例死亡（25%分位数至 97.5%分位数：1.2-1.6）。每年还估计因肠套叠住院的人数为 5.0 例（25%分位数至 97.5%分位数：3.2-7.7）和 0.005 例死亡（25%分位数至 97.5%分位数：0.001-0.015）。因此，肠套叠住院的获益风险比为 214（25%分位数至 97.5%分位数：128-362），死亡的获益风险比为 273（25%分位数至 97.5%分位数：89-1228）。在假设接种率为 92%的情况下，Rotarix 轮状病毒疫苗接种每年可预防 10459 例 RVGE 住院（25%分位数至 97.5%分位数：7702-13498），并导致 47.0 例肠套叠住院（25%分位数至 97.5%分位数：25.1-81.4），从而预防 13.7 例死亡（25%分位数至 97.5%分位数：11.1-15.2）和 0.05 例死亡（25%分位数至 97.5%分位数：0.01-0.15）。法国的获益风险比与其他欧洲国家相似。
