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    Case-control evaluation of the effectiveness of the G1P[8] human rotavirus vaccine during an outbreak of rotavirus G2P[4] infection in central Australia

    Access Status
    Open access via publisher
    Authors
    Snelling, Thomas
    Andrews, R.
    Kirkwood, C.
    Culvenor, S.
    Carapetis, J.
    Date
    2011
    Collection
    • Curtin Research Publications
    Type
    Journal Article
    Metadata
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    Abstract

    Summary: The human rotavirus vaccine was evaluated during an outbreak of rotavirus G2P[4] infection in central Australia. No overall protective effect against hospitalization was demonstrated, raising concerns over the durability of vaccine protection against heterotypic strains. Background: Two and a half years after commencing routine vaccination with human rotavirus vaccine, an outbreak of rotavirus G2P[4] infection occurred in central Australia. Vaccine effectiveness against a P[8]-containing strain (G9P[8] ) had been demonstrated previously in this setting. This subsequent outbreak provided the opportunity to evaluate vaccine effectiveness against hospitalizations for a non-vaccine-related genotype in the same population. Methods: A case-control study was nested within a cohort of vaccine-eligible children listed on a populationbased immunization register. Children with rotavirus-confirmed gastroenteritis were individually matched by date of birth and Indigenous status with 4 control subjects. Results: Forty-one cases met the inclusion criteria, and 21 were severe cases among infants aged < 12 months. Nineteen (46%) of 41 case patients had received 2 doses of human rotavirus vaccine, compared with 87 (53%) of 164 control subjects. Vaccine effectiveness against rotavirus-related hospitalization was 19% (odds ratio,.81; 95% confidence interval,.32-2.05) for 2 doses compared with none. On secondary analysis, there was evidence of a protective effect against disease complicated by acidosis in the subset of infants aged < 12 months (odds ratio,.15; 95% confidence interval,.03-.84). Conclusions. Evidence was not found for an overall protective effect of human rotavirus vaccine against hospitalization for rotavirus disease in this setting. Post hoc analyses suggested a protective effect against severe disease in young infants. © The Author 2011.

    Citation
    Snelling, T. and Andrews, R. and Kirkwood, C. and Culvenor, S. and Carapetis, J. 2011. Case-control evaluation of the effectiveness of the G1P[8] human rotavirus vaccine during an outbreak of rotavirus G2P[4] infection in central Australia. Clinical Infectious Diseases. 52 (2): pp. 191-199.
    Source Title
    Clinical Infectious Diseases
    URI
    http://hdl.handle.net/20.500.11937/55625
    DOI
    10.1093/cid/ciq101
    Department
    School of Public Health

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