澳大利亚人群中轮状病毒疫苗的有效性：病例对照研究。
Effectiveness of rotavirus vaccines in an Australian population: A case-control study.
机构信息
School of Population and Global Health, University of Western Australia, 35 Stirling Highway, Perth Western Australia 6009, Australia; Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Western Australia 6872, Australia.
Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Western Australia 6872, Australia; Department of Infectious Diseases, Perth Children's Hospital, Locked Bag 2010, Nedlands, Western Australia 6909, Australia; Menzies School of Health Research and Charles Darwin University, PO Box 41096, Casuarina, NT 0811, Australia; School of Public Health, Curtin University, GPO Box U1987, Perth 6845, Australia.
出版信息
Vaccine. 2019 Sep 24;37(41):6048-6053. doi: 10.1016/j.vaccine.2019.08.047. Epub 2019 Aug 28.
OBJECTIVE
Two rotavirus vaccines (RV1 and RV5) were included in the publicly funded National Immunisation Program in Australia from July 2007. The programme in Western Australia initially provided RV1 (at ages 2 and 4 months) and then switched to RV5 (at ages 2, 4 and 6 months) from July 2009. This retrospective case-control study was conducted to assess the effectiveness of rotavirus vaccine against laboratory confirmed and notified cases of rotavirus infection among children aged <5 years.
METHODS
Case-subjects were identified as vaccine-eligible children (born from 1 May 2007) who were notified as having rotavirus infection during the period 2009-2011. The control group was vaccine-eligible children notified as having Campylobacter or Salmonella infection during the same period. Individual rotavirus immunisation status was ascertained from a population-based immunisation register. Full-dose and partial-dose vaccine effectiveness (VE) were calculated for both vaccines using the adjusted odds ratio (OR) of vaccination for cases versus controls (VE = (1 - OR)*100%).
RESULTS
Overall, 282 cases and 883 controls were included. The adjusted VE for a full course of either rotavirus vaccine was 72% (95% CI: 56-82) and 71% (95% CI: 50-84) for partial vaccination (one dose of RV1 or one/two doses of RV5). The VE for a complete 3-dose course of RV5 was 82% (95% CI: 59-92) and for a full 2-dose course of RV1 was 73% (95% CI: 55-83).
CONCLUSIONS
RV1 and RV5 were both effective in preventing laboratory confirmed and notified rotavirus infections among children aged <5 years. Even incomplete courses of vaccination conferred good protection.
目的
自 2007 年 7 月起，两种轮状病毒疫苗（RV1 和 RV5）被纳入澳大利亚公共资助的国家免疫计划。西澳大利亚州的计划最初提供 RV1（在 2 个月和 4 个月龄时），然后从 2009 年 7 月起改为 RV5（在 2、4 和 6 个月龄时）。本回顾性病例对照研究旨在评估轮状病毒疫苗对 5 岁以下儿童实验室确诊和报告的轮状病毒感染病例的有效性。
方法
将病例组确定为符合疫苗接种条件的儿童（2007 年 5 月 1 日出生），他们在 2009-2011 年期间被通知患有轮状病毒感染。对照组为同期被通知患有弯曲杆菌或沙门氏菌感染的符合疫苗接种条件的儿童。个体轮状病毒免疫状况从基于人群的免疫登记处确定。使用病例与对照组之间接种疫苗的调整比值比（OR）计算两种疫苗的全剂量和部分剂量疫苗有效性（VE）（VE=（1-OR）*100%）。
结果
共有 282 例病例和 883 例对照组纳入研究。全剂量 RV1 或 RV5 疫苗接种的调整 VE 分别为 72%（95%CI：56-82）和 71%（95%CI：50-84），部分剂量（RV1 一剂或 RV5 一剂/两剂）分别为 72%（95%CI：56-82）和 71%（95%CI：50-84）。RV5 完整 3 剂疗程的 VE 为 82%（95%CI：59-92），RV1 完整 2 剂疗程的 VE 为 73%（95%CI：55-83）。
结论
RV1 和 RV5 均能有效预防 5 岁以下儿童实验室确诊和报告的轮状病毒感染。即使不完全的疫苗接种疗程也能提供良好的保护。
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