Division on Nursing Sciences, Midwifery, Department of Health Sciences, Faculty of Medical Sciences, Kyushu University Faculty of Medical Sciences, Fukuoka, Japan.
Division of Microbiology, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan.
Hum Vaccin Immunother. 2021 Oct 3;17(10):3613-3618. doi: 10.1080/21645515.2021.1925060. Epub 2021 May 25.
Although two live oral rotavirus (RV) vaccines, Rotarix and RotaTeq, play a critical role toward reducing disease severity, hospitalization, and death rate in RV infections, regular monitoring of vaccine effectiveness (VE) is yet necessary because the segmented genome structure and reassortment capability of RVs pose considerable threats toward waning VE. In this study, we examined the VE by a test-negative study design against G9P[8]I2 strain during a seasonal outbreak in February-May, 2018, in an outpatient clinic in Kyoto Prefecture, Japan. It remains important because G9P[8]I2 strain remains partially heterotypic to these vaccines and predominating in post-vaccination era. During year-long surveillance, RV infections were detected only from February to May. During this outbreak, 33 (42.3%) children out of 78 with acute gastroenteritis (AGE) remained RV-positive, of which 29 (87.8%) children were infected with G9P[8]I2. Two immunochromatographic (IC) assay kits exhibited 100% sensitivity and specificity to detect G9P[8]I2 strain. Only 23.2% children were found to be vaccinated. Yet, significant VE 69.7% (95% CI: 2.5%-90.6%) was recognized against all RV strains that increased with disease severity. Similar significant VE 71.8% (95% CI: 1%-92%) was determined against G9P[8]I2 strain. The severity score remained substantially low in vaccinated children. Our data reveal that vaccine-preventable G9P[8]I2 strain yet may cause outbreak where vaccination coverage remains low. Thus, this study emphasizes the necessity of global introduction of RV-vaccines in national immunization programs of every country.
虽然两种活的口服轮状病毒（RV）疫苗，Rotarix 和 RotaTeq，在降低 RV 感染的疾病严重程度、住院率和死亡率方面发挥了关键作用，但仍有必要定期监测疫苗的有效性（VE），因为 RV 的分段基因组结构和重组能力对 VE 的下降构成了相当大的威胁。在这项研究中，我们采用了一种阴性测试研究设计，针对 G9P[8]I2 株在 2018 年 2 月至 5 月日本京都府一家门诊诊所的季节性暴发中进行了 VE 检测。这一点很重要，因为 G9P[8]I2 株仍然对这些疫苗部分具有异型性，并且在疫苗接种后时代占主导地位。在长达一年的监测期间，仅在 2 月至 5 月检测到 RV 感染。在这次暴发期间，78 名急性胃肠炎（AGE）患儿中有 33 名（42.3%）RV 阳性，其中 29 名（87.8%）患儿感染了 G9P[8]I2。两种免疫层析（IC）检测试剂盒对 G9P[8]I2 株的检测均具有 100%的敏感性和特异性。仅发现 23.2%的儿童接受了疫苗接种。然而，对所有 RV 株的 VE 为 69.7%（95%CI：2.5%-90.6%），并且随着疾病严重程度的增加而增加。对 G9P[8]I2 株也确定了类似的显著 VE 71.8%（95%CI：1%-92%）。在接种疫苗的儿童中，严重程度评分仍然很低。我们的数据表明，疫苗可预防的 G9P[8]I2 株仍可能导致接种率较低的暴发。因此，本研究强调了在每个国家的国家免疫规划中引入全球 RV 疫苗的必要性。
