Middleton Bianca F, Danchin Margie, Quinn Helen, Ralph Anna P, Pingault Nevada, Jones Mark, Estcourt Marie, Snelling Tom
Global and Tropical Health, Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia.
Division of Women, Children and Youth, Royal Darwin Hospital, Darwin 0810, Australia.
Pathogens. 2020 Sep 26;9(10):790. doi: 10.3390/pathogens9100790.
A widespread G2P[4] rotavirus epidemic in rural and remote Australia provided an opportunity to evaluate the performance of Rotarix and RotaTeq rotavirus vaccines, ten years after their incorporation into Australia's National Immunisation Program.
We conducted a retrospective case-control analysis. Vaccine-eligible children with laboratory-confirmed rotavirus infection were identified from jurisdictional notifiable infectious disease databases and individually matched to controls from the national immunisation register, based on date of birth, Aboriginal status and location of residence.
171 cases met the inclusion criteria; most were Aboriginal and/or Torres Strait Islander (80%) and the median age was 19 months. Of these cases, 65% and 25% were fully or partially vaccinated, compared to 71% and 21% of controls. Evidence that cases were less likely than controls to have received a rotavirus vaccine dose was weak, OR 0.79 (95% CI, 0.46-1.34). On pre-specified subgroup analysis, there was some evidence of protection among children <12 months (OR 0.48 [95% CI, 0.22-1.02]), and among fully vs. partially vaccinated children (OR 0.65 [95% CI, 0.42-1.01]).
Despite the known effectiveness of rotavirus vaccination, a protective effect of either rotavirus vaccine during a G2P[4] outbreak in these settings among predominantly Aboriginal children was weak, highlighting the ongoing need for a more effective rotavirus vaccine and public health strategies to better protect Aboriginal children.
在澳大利亚农村和偏远地区广泛流行的G2P[4]轮状病毒疫情，为评估Rotarix和RotaTeq轮状病毒疫苗纳入澳大利亚国家免疫规划十年后的效果提供了契机。
我们进行了一项回顾性病例对照分析。从各辖区法定传染病数据库中识别出实验室确诊的轮状病毒感染且符合疫苗接种条件的儿童，并根据出生日期、原住民身份和居住地点，将其与国家免疫登记册中的对照个体进行匹配。
171例病例符合纳入标准；大多数为原住民和/或托雷斯海峡岛民（80%），中位年龄为19个月。在这些病例中，65%和25%的儿童接受了全程或部分疫苗接种，而对照儿童的这一比例分别为71%和21%。病例比对照接受轮状病毒疫苗接种剂量的可能性更低的证据较弱，比值比为0.79（95%置信区间，0.46 - 1.34）。在预先设定的亚组分析中，有一些证据表明，12个月以下儿童（比值比0.48 [95%置信区间，0.22 - 1.02]）以及全程接种与部分接种疫苗的儿童（比值比0.65 [95%置信区间，0.42 - 1.01]）中存在疫苗保护作用。
尽管已知轮状病毒疫苗有效，但在这些地区以原住民儿童为主的G2P[4]疫情期间，两种轮状病毒疫苗的保护作用均较弱，这突出表明持续需要更有效的轮状病毒疫苗和公共卫生策略，以更好地保护原住民儿童。
