Asare Ernest O, Al-Mamun Mohammad A, Armah George E, Lopman Benjamin A, Pitzer Virginia E
Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT, USA.
Public Health Modeling Unit, Yale School of Public Health, Yale University, New Haven, CT, USA.
Sci Adv. 2024 Dec 13;10(50):eadn4176. doi: 10.1126/sciadv.adn4176. Epub 2024 Dec 11.
There is currently limited evidence regarding how the rotavirus vaccine dosing schedule might be adjusted to improve vaccine performance. We quantified the impact of the previously implemented 6/10-week Rotarix vaccine (RV1) in Ghana to the model-predicted impact for other vaccine dosing schedules across three hospitals and the entire country. Compared to no vaccination, the model-estimated median percentage reductions in rotavirus ranged from 28 to 85% and 12 to 71% among children <1 and <5 years old, respectively. The median predicted reductions in rotavirus for the whole country ranged from 57 to 66% among infants <1 year and 35 to 45% among children <5 years old. The 1/6/10- and 6/10/14-week schedules provided the best and comparable reductions in rotavirus compared to the original 6/10-week schedule. A third dose could prevent an additional 9 to 14% of deaths. An additional dose of RV1 might be an effective strategy to improve rotavirus vaccine impact, particularly in settings with low vaccine effectiveness.
目前，关于如何调整轮状病毒疫苗接种程序以提高疫苗效果的证据有限。我们对加纳之前实施的6/10周龄罗特威疫苗（RV1）的影响进行了量化，并与模型预测的其他疫苗接种程序在三家医院及全国范围内的影响进行了比较。与未接种疫苗相比，模型估计1岁以下和5岁以下儿童轮状病毒感染率的中位数降幅分别为28%至85%和12%至71%。全国范围内，模型预测1岁以下婴儿轮状病毒感染率的中位数降幅为57%至66%，5岁以下儿童为35%至45%。与最初的6/10周接种程序相比，1/6/10周和6/10/14周接种程序对轮状病毒感染率的降低效果最佳且相当。第三剂疫苗可额外预防9%至14%的死亡。额外接种一剂RV1可能是提高轮状病毒疫苗效果的有效策略，尤其是在疫苗效果较低的环境中。
