June 26, 2014
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Rotavirus vaccination prevented associated hospitalizations in German children

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Recent data show rotavirus vaccination reduced rotavirus-associated hospitalizations among German children. Further, effectiveness did not differ between the two vaccines, Rotarix and Rotateq.

Ulrike Uhlig, MD, of the John Radcliffe Hospital in Oxford, United Kingdom, and colleagues assessed rotavirus vaccination use, case notification, and hospitalization among children aged 0 to 5 years in Germany from 2006 through 2011. Researchers compared the effectiveness of Rotateq (RV5, Merck) and Rotarix (RV1, GlaxoSmithKline). There were 4.2 to 4 million children aged younger than 6 years during the study period; researchers focused on a subgroup of children aged 0 to 1 year who were vaccinated with RV5 (n=18,025) or RV1 (n=19,936).

Two regions had different levels of rotavirus vaccination coverage. The area formerly known as East Germany, excluding Berlin, had high vaccination coverage; and the area formerly known as West Germany, including Berlin, had low vaccination coverage. In 2012, the rotavirus vaccination coverage rate was 26% in the low-coverage area, compared with 65% in the high-coverage area.

There was a significant decrease in notified laboratory-confirmed rotavirus cases among children younger than 1 year. Compared with 2006, there were 74% less rotavirus cases in the high-coverage area and 49% less rotavirus cases in the low-coverage are in 2010. Reduction of rotavirus notification was directly associated with vaccine coverage of particular federal states. During the study period, rotavirus-associated hospital admissions decreased by 60% in the high-coverage area and by 19% in the low-coverage area.

There was not a significant decrease in norovirus hospitalizations. However, when all gastroenteritis-related diagnoses were grouped together, there was a significant decrease in hospital admissions; suggesting a high rotavirus vaccination coverage rate prevents a relevant proportion of non-specific gastroenteritis-associated hospitalizations.

Baseline admission rates for norovirus and airway infections were higher in the high-coverage area. Hospitalization rates for Kawasaki disease were insignificant.

For both vaccines, 88% of vaccinated children were free from rotavirus gastroenteritis 5 years after vaccination.

Rotavirus vaccination coverage is low in Germany, compared with several European countries and the United States, according to researchers.

“Our data suggest that rotavirus vaccination is effective in preventing rotavirus hospitalization in Germany. There is evidence that both vaccines are similarly effective in preventing rotavirus-associated morbidity requiring ambulatory medical care. We could not detect substantial side effects,” they concluded.

Disclosure: The researchers have financial ties with GlaxoSmithKline, Essex Pharma, Merck, and Sanofi Pasteur.