Department of Public Health, HSE Dublin Mid-Leinster, Dublin, Ireland.
Eur J Public Health. 2020 Apr 1;30(2):281-285. doi: 10.1093/eurpub/ckz238.
Rotavirus vaccine efficacy is well established. However, it is important to consistently demonstrate the positive impact of vaccination programmes in order to optimize uptake rates and combat vaccine hesitancy.
Routine data were used to examine rotavirus vaccine effectiveness in Ireland, including changes in age-specific crude incidence rates (CIRs), hospitalizations and hospital length of stay. National intussusception incidence was interrogated. Vaccination status of vaccine-eligible cases of rotavirus infection was determined.
Nationally, a reduction in the CIR of rotavirus infection of 77.2% [95% confidence interval (CI) 57.8-88.5%, P<0.001] was observed post-inclusion of the rotavirus vaccine in the primary immunization schedule. A decrease in hospitalizations of 85.5% (95% CI 79.3-90.2%, P<0.001), 86.5% (95% CI 82.9-89.4%, P<0.001) and 78.5% (95% CI 74.7-81.9%, P<0.001) was observed in children aged <1, <2 and <5 years, respectively. Most hospitalizations occurred in infants too young to have been vaccinated. There was no significant difference in median length of stay for children hospitalized with rotavirus infection. Decreased CIRs and hospitalization rates in unvaccinated children aged between 2 and 5 years suggest community immunity. Vaccine non-protection was 0.13%. No increase in the national CIR of intussusception was observed.
Inclusion of the rotavirus vaccine in the Irish primary immunization schedule has resulted in a significant reduction in the burden of rotavirus infection. However, vaccine hesitancy remains a concern. With new vaccination programmes, risk of vaccine harms should be considered and mitigated in order to protect individuals and the integrity of the programme.
轮状病毒疫苗的有效性已得到充分证实。然而，为了优化疫苗接种率并应对疫苗犹豫，持续证明疫苗接种计划的积极影响非常重要。
使用常规数据来检查爱尔兰轮状病毒疫苗的有效性，包括特定年龄组粗发病率（CIR）、住院和住院时间的变化。调查全国肠套叠发病率。确定轮状病毒感染疫苗合格病例的疫苗接种情况。
在全国范围内，轮状病毒疫苗纳入初级免疫计划后，轮状病毒感染的 CIR 降低了 77.2%[95%置信区间（CI）57.8-88.5%，P<0.001]。住院率下降了 85.5%（95%CI 79.3-90.2%，P<0.001），86.5%（95%CI 82.9-89.4%，P<0.001）和 78.5%（95%CI 74.7-81.9%，P<0.001）分别为<1 岁、<2 岁和<5 岁的儿童。大多数住院的儿童年龄太小，无法接种疫苗。因轮状病毒感染住院的儿童平均住院时间没有显著差异。未接种疫苗的 2 至 5 岁儿童的 CIR 和住院率下降表明存在社区免疫力。疫苗无保护率为 0.13%。未观察到全国肠套叠 CIR 的增加。
将轮状病毒疫苗纳入爱尔兰初级免疫计划已显著降低了轮状病毒感染的负担。然而，疫苗犹豫仍然是一个问题。随着新的疫苗接种计划，应考虑疫苗危害的风险，并加以缓解，以保护个人和计划的完整性。
