GP188 Hospitalisation with rotavirus gastroenteritis before and after rotavirus vaccine introduction

Rotavirus is responsible for 26% of diarrheal deaths in Latin America and the Caribbean. Haiti introduced the monovalent rotavirus vaccine in April 2014. The objective of this analysis is to describe the impact of the rotavirus vaccine on hospitalizations among Haitian children younger than 5 years old during the first 5 years after introduction. This analysis includes all children with diarrhea who were enrolled as part of a sentinel surveillance system at two hospitals from May 2013 to April 2019. We compare the proportion of rotavirus-positive specimens in each post-vaccine introduction year to the pre-vaccine period. To account for the potential dilution of the proportion of rotavirus-positive specimens from a waning cholera outbreak, we also analyzed annual trends in the absolute number of positive stools, fit a two-component finite-mixture model to the negative specimens, and fit a negative binomial time series model to the pre-vaccine rotavirus-positive specimens to predict the number of rotavirus diarrhea hospital admissions in the absence of rotavirus vaccination. The overall percentage of rotavirus-positive specimens declined by 22% the first year after introduction, increased by 17% the second year, and declined by 33% to 50% the subsequent 3 years. All sensitivity analyses confirmed an overall decline. We observed a clear annual rotavirus seasonality before and after vaccine introduction, with the greatest activity in December through April, and a biennial pattern, with high sharp peaks and flatter longer periods of increased rotavirus activity in alternating years, consistent with suboptimal vaccination coverage. Overall, our study shows evidence that the introduction of the rotavirus vaccine reduced the burden of severe rotavirus diarrhea.

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Epidemiology of intussusception before and after rotavirus vaccine introduction in Fiji

Scientific Reports ◽

10.1038/s41598-018-29515-2 ◽

2018 ◽

Vol 8 (1) ◽

Cited By ~ 2

Author(s):

Felisita Tupou Ratu ◽

Rita Reyburn ◽

Evelyn Tuivaga ◽

Asena Tuiketei ◽

Kylie Jenkins ◽

...

Keyword(s):

Rotavirus Vaccine ◽

Vaccine Introduction ◽

Before And After

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Global Impact of Rotavirus Vaccination on Diarrhea Hospitalizations and Deaths Among Children <5 Years Old: 2006–2019

The Journal of Infectious Diseases ◽

10.1093/infdis/jiaa081 ◽

2020 ◽

Vol 222 (10) ◽

pp. 1731-1739 ◽

Cited By ~ 13

Author(s):

Eleanor Burnett ◽

Umesh D Parashar ◽

Jacqueline E Tate

Keyword(s):

Age Groups ◽

Published Data ◽

Rotavirus Vaccine ◽

Immunization Programs ◽

Median Percentage ◽

Global Impact ◽

Vaccine Introduction ◽

Rotavirus Vaccination ◽

Younger Age ◽

Before And After

Abstract Background Since 2006, more than 100 countries have introduced rotavirus vaccine into their immunization programs. We reviewed published data on relative reductions of rotavirus hospitalizations, acute gastroenteritis (AGE) hospitalizations, and AGE deaths among children <5 years old. Methods Articles published from January 1, 2006 to December 31, 2019 with at least 12 months of data before and after rotavirus vaccine introduction were included. Relative reductions were abstracted into a standardized form. Descriptive statistics are presented as medians and interquartile ranges (IQRs). Results We reviewed 1827 total records and included 105 articles from 49 countries. Among children <5 years old, there was a median reduction of 59% (IQR, 46–74) in rotavirus hospitalizations, 36% (IQR, 23–47) in AGE hospitalizations, and 36% (IQR, 28–46) AGE mortality. Reductions were larger in countries with low child mortality, among younger age groups, and in countries with higher coverage. The median percentage of specimens that tested positive for rotavirus among children <5 years old hospitalized for diarrhea was 40% (IQR, 28–45) before rotavirus vaccine introduction and 20% (IQR, 20–20) 4 years after introduction. Conclusions Overall, we found sustained impact on rotavirus and AGE hospitalizations and deaths. These results should encourage countries still considering rotavirus vaccine implementation.

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Molecular epidemiology of rotavirus gastroenteritis in Japan during 2014-2015: Characterization of re-emerging G2P[4] after rotavirus vaccine introduction

Journal of Medical Virology ◽

10.1002/jmv.25067 ◽

2018 ◽

Vol 90 (6) ◽

pp. 1040-1046 ◽

Cited By ~ 9

Author(s):

Nusrat Khandoker ◽

Aksara Thongprachum ◽

Sayaka Takanashi ◽

Shoko Okitsu ◽

Shuichi Nishimura ◽

...

Keyword(s):

Molecular Epidemiology ◽

Rotavirus Vaccine ◽

Vaccine Introduction ◽

Rotavirus Gastroenteritis

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Diarrheal Diseases Hospitalization in Yemen before and after Rotavirus Vaccination

Scientifica ◽

10.1155/2016/8485417 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Mohammed Amood AL-Kamarany ◽

Lina Al-Areqi ◽

Abulatif Mujally ◽

Fawzya Alkarshy ◽

Arwa Nasser ◽

...

Keyword(s):

Vaccine Coverage ◽

Rotavirus Vaccine ◽

Diarrheal Diseases ◽

Predominant Genotype ◽

Fecal Samples ◽

Vaccine Introduction ◽

Rotavirus Vaccination ◽

Before And After ◽

Rotavirus Diarrhea ◽

The Impact

The study aims to assess the impact of rotavirus vaccine introduction on diarrheal diseases hospitalization and to identify the rotavirus genotypes most prevalent before and after vaccine introduction among children ≤ 5 years of age. Rotarix™® rotavirus vaccine is currently licensed for infants in Yemen and was introduced in 2012. The vaccination course consists of two doses. The first dose is administrated at 6 weeks of age and the second dose is completed by 10 weeks. Based on a longitudinal observational study, we assessed the impact of vaccination on rotavirus hospitalization before and after vaccination among children ≤ 5 years of age at the Yemeni-Swedish Hospital (YSH) in Taiz, Yemen. Prevaccination covered January 2009–July 2012 during which 2335 fecal samples were collected from children ≤ 5 years old. Postvaccination covered January 2013–December 2014 during which 1114 fecal samples were collected. Rotavirus was detected by Enzyme Linkage Immunosorbent Assay (ELISA). The incidence ofrotavirushospitalization decreased from 43.79% in 2009 to 10.54% in 2014. Hospitalization due to rotavirus diarrhea was reduced by 75.93%. Vaccine coverage increased from 23% in 2012 to 72% in 2014. Also, the results showed that the most predominant genotypes in prevaccination period were G2P[4] (55.0%), followed by G1P[8] (15.0%), while in postvaccination period G1P[8] (31%) was the predominant genotype, followed by G9P[8] (27.5%). In conclusion, rotavirus vaccination in Yemen resulted in sharp reduction in diarrheal hospitalization. A successful rotavirus vaccination program in Yemen will rely upon efficient vaccine delivery systems and sustained vaccine efficacy against diverse and evolving rotavirus strains.

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Trends in Rate of Seizure-Associated Hospitalizations Among Children <5 Years Old Before and After Rotavirus Vaccine Introduction in the United Sates, 2000–2013

The Journal of Infectious Diseases ◽

10.1093/infdis/jix589 ◽

2018 ◽

Vol 217 (4) ◽

pp. 581-588 ◽

Cited By ~ 10

Author(s):

Kimberly D Pringle ◽

Rachel M Burke ◽

Claudia A Steiner ◽

Umesh D Parashar ◽

Jacqueline E Tate

Keyword(s):

Rotavirus Vaccine ◽

Vaccine Introduction ◽

Before And After

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Emergence of Double- and Triple-Gene Reassortant G1P[8] Rotaviruses Possessing a DS-1-Like Backbone after Rotavirus Vaccine Introduction in Malawi

Journal of Virology ◽

10.1128/jvi.01246-17 ◽

2017 ◽

Vol 92 (3) ◽

Cited By ~ 15

Author(s):

Khuzwayo C. Jere ◽

Chrispin Chaguza ◽

Naor Bar-Zeev ◽

Jenna Lowe ◽

Chikondi Peno ◽

...

Keyword(s):

Amino Acid ◽

Vaccine Effectiveness ◽

Recent Common Ancestor ◽

Rotavirus Vaccine ◽

Careful Evaluation ◽

African Countries ◽

Vaccine Introduction ◽

Rotavirus Gastroenteritis ◽

Structural Conformation ◽

Rotavirus Vaccines

ABSTRACT To combat the high burden of rotavirus gastroenteritis, multiple African countries have introduced rotavirus vaccines into their childhood immunization programs. Malawi incorporated a G1P[8] rotavirus vaccine (Rotarix) into its immunization schedule in 2012. Utilizing a surveillance platform of hospitalized rotavirus gastroenteritis cases, we examined the phylodynamics of G1P[8] rotavirus strains that circulated in Malawi before (1998 to 2012) and after (2013 to 2014) vaccine introduction. Analysis of whole genomes obtained through next-generation sequencing revealed that all randomly selected prevaccine G1P[8] strains sequenced ( n = 32) possessed a Wa-like genetic constellation, whereas postvaccine G1P[8] strains ( n = 18) had a DS-1-like constellation. Phylodynamic analyses indicated that postvaccine G1P[8] strains emerged through reassortment events between human Wa- and DS-1-like rotaviruses that circulated in Malawi from the 1990s and hence were classified as atypical DS-1-like reassortants. The time to the most recent common ancestor for G1P[8] strains was from 1981 to 1994; their evolutionary rates ranged from 9.7 × 10 −4 to 4.1 × 10 −3 nucleotide substitutions/site/year. Three distinct G1P[8] lineages chronologically replaced each other between 1998 and 2014. Genetic drift was the likely driver for lineage turnover in 2005, whereas replacement in 2013 was due to reassortment. Amino acid substitution within the outer glycoprotein VP7 of G1P[8] strains had no impact on the structural conformation of the antigenic regions, suggesting that it is unlikely that they would affect recognition by vaccine-induced neutralizing antibodies. While the emergence of DS-1-like G1P[8] rotavirus reassortants in Malawi was therefore likely due to natural genotype variation, vaccine effectiveness against such strains needs careful evaluation. IMPORTANCE The error-prone RNA-dependent RNA polymerase and the segmented RNA genome predispose rotaviruses to genetic mutation and genome reassortment, respectively. These evolutionary mechanisms generate novel strains and have the potential to lead to the emergence of vaccine escape mutants. While multiple African countries have introduced a rotavirus vaccine, there are few data describing the evolution of rotaviruses that circulated before and after vaccine introduction. We report the emergence of atypical DS-1-like G1P[8] strains during the postvaccine era in Malawi. Three distinct G1P[8] lineages circulated chronologically from 1998 to 2014; mutation and reassortment drove lineage turnover in 2005 and 2013, respectively. Amino acid substitutions within the outer capsid VP7 glycoprotein did not affect the structural conformation of mapped antigenic sites, suggesting a limited effect on the recognition of G1-specific vaccine-derived antibodies. The genes that constitute the remaining genetic backbone may play important roles in immune evasion, and vaccine effectiveness against such atypical strains needs careful evaluation.

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