Division of Viral Diseases, NCIRD, CDC, USA.
CDC Country Office, Port-au-Prince, Haiti.
Vaccine. 2021 Jul 22;39(32):4458-4462. doi: 10.1016/j.vaccine.2021.06.055. Epub 2021 Jun 27.
Rotavirus vaccines are effective in preventing severe rotavirus. Haiti introduced 2-dose monovalent (G1P[8]) rotavirus vaccine recommended for infants at 6 and 10 weeks of age in 2014. We calculated the effectiveness of rotavirus vaccine against hospitalization for acute gastroenteritis in Haiti.
We enrolled children 6-59 months old admitted May 2014-September 2019 for acute watery diarrhea at any sentinel surveillance hospital. Stool was tested for rotavirus using enzyme immunoassay (EIA) and genotyped with multiplex one-step RT-PCR assay and Sanger sequencing for stratification by genotype. We used a case-negative design where cases were children positive for rotavirus and controls were negative for rotavirus. Only children eligible for vaccination were included and a child was considered vaccinated if vaccine was given ≥ 14 days before enrollment. We used unconditional logistic regression to calculate odds ratios and calculated 2-dose and 1-dose vaccine effectiveness (VE) as (1 - odds ratio) * 100.
We included 129 (19%) positive cases and 543 (81%) negative controls. Among cases, 77 (60%) were positive for equine-like G3P[8]. Two doses of rotavirus vaccine were 66% (95% CI: 44, 80) effective against hospitalizations due to any strain of rotavirus and 64% (95% CI: 33, 81) effective against hospitalizations due to the equine-like G3P[8] genotype.
These findings are comparable to other countries in the Americas region. To the best of our knowledge, this is the first VE estimate both against the equine-like G3P[8] genotype and from a Caribbean country. Overall, these results support rotavirus vaccine use and demonstrate the importance of complete vaccination.
轮状病毒疫苗可有效预防严重轮状病毒。海地于 2014 年引入了两剂单价（G1P[8]）轮状病毒疫苗，建议婴儿在 6 周和 10 周龄时接种。我们计算了轮状病毒疫苗在海地预防急性胃肠炎住院的效果。
我们招募了 2014 年 5 月至 2019 年 9 月期间在任何哨点监测医院因急性水样腹泻住院的 6-59 月龄儿童。使用酶联免疫吸附试验（EIA）检测粪便中的轮状病毒，并使用多重一步 RT-PCR 检测和 Sanger 测序进行基因分型，以按基因型进行分层。我们采用病例对照设计，病例为轮状病毒阳性儿童，对照为轮状病毒阴性儿童。仅纳入有资格接种疫苗的儿童，如果疫苗接种时间在入组前≥14 天，则认为该儿童接种了疫苗。我们使用无条件逻辑回归计算比值比，并计算两剂和一剂轮状病毒疫苗的有效性（VE）为（1-比值比）*100。
我们纳入了 129 例（19%）阳性病例和 543 例（81%）阴性对照。在病例中，77 例（60%）为马科样 G3P[8]阳性。两剂轮状病毒疫苗对任何轮状病毒株引起的住院的有效性为 66%（95%CI：44，80），对马科样 G3P[8]基因型引起的住院的有效性为 64%（95%CI：33，81）。
这些发现与美洲地区的其他国家相似。据我们所知，这是第一项针对马科样 G3P[8]基因型和加勒比国家的疫苗有效性估计。总体而言，这些结果支持使用轮状病毒疫苗，并证明了完全接种疫苗的重要性。
