Impact and effectiveness of monovalent rotavirus vaccine in Tajik children

Vaccine. 2022 Jun 9;40(26):3705-3712. doi: 10.1016/j.vaccine.2022.05.018. Epub 2022 May 14.

Abstract

Background: In 2015, Tajikistan became the second country in Central Asia to introduce rotavirus vaccine into its national immunization program. Before vaccine introduction, rotavirus was estimated to cause > 40% of pediatric diarrhea hospitalizations in Tajikistan. We aimed to assess the impact of rotavirus vaccine introduction on rotavirus disease burden and estimate rotavirus vaccine effectiveness (VE).

Methods: Using surveillance data from 2013 through 2019, we examined trends in monthly hospital admissions among children < 5 years old, before and after rotavirus vaccine introduction. Poisson regression was used to quantify decreases. VE was estimated using a test-negative case control design, with data from admissions during 2017 - 2019. Immunization records were obtained from clinics.

Results: Among enrolled children, rotavirus positivity declined from 42% to 25% in the post-vaccine introduction period, a decrease of 41% (95% Confidence Interval [CI]: 36 - 45%). Declines were greatest in children < 12 months of age. Estimated VE of a complete course of rotavirus vaccine was 55% (95% CI: 21 - 73%) among children 5 - 59 months of age and 64% (95% CI: 36 - 80%) among children 5 - 23 months of age. VE point estimates were higher among children receiving both doses of rotavirus vaccine non-concurrently with OPV and among children receiving their first dose of rotavirus vaccine at 4 - 11 months of age, but CIs were wide and overlapping.

Conclusions: Our data demonstrate that rotavirus vaccine introduction was associated with a substantial reduction in pediatric rotavirus hospitalization burden in Tajikistan, and that rotavirus vaccination is effective in Tajik children.

Keywords: Pediatric gastroenteritis; Rotavirus; Rotavirus vaccines; Vaccine effectiveness.

MeSH terms

  • Child
  • Child, Preschool
  • Gastroenteritis* / epidemiology
  • Gastroenteritis* / prevention & control
  • Hospitalization
  • Humans
  • Immunization Programs
  • Infant
  • Rotavirus Infections* / epidemiology
  • Rotavirus Infections* / prevention & control
  • Rotavirus Vaccines*
  • Rotavirus*
  • Vaccination
  • Vaccines, Attenuated

Substances

  • Rotavirus Vaccines
  • Vaccines, Attenuated