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Rotavirus Vaccine Effectiveness and Case-control Study on Risk Factors for Breakthrough Infections in Germany, 2010-2011.
MedLine Citation:
PMID:  23334342     Owner:  NLM     Status:  Publisher    
BACKGROUND:: In the German federal state Mecklenburg-Western Pomerania, routine rotavirus (RV) vaccination in infants has been recommended since 2009. The effectiveness of RV vaccination was investigated after an unexpectedly high number of RV infections in fully vaccinated children occurred. METHODS:: Intensified RV surveillance was performed in Mecklenburg-Western Pomerania between 2010 and 2011. The screening method was applied to assess vaccine effectiveness (VE) in children up to 24 months after vaccination. To identify risk factors for breakthrough infections, a case-control study and genotyping were conducted in vaccinated and unvaccinated RV-infected children. RESULTS:: VE for the prevention of RV infection requiring medical attention or hospitalization was 68% (95% confidence interval [CI]: 61-71) and 80% (95% CI: 77-83), respectively. VE for preventing hospitalization but not medical attention remained stable over 2 years. Vaccinated were less often hospitalized (23%) than unvaccinated RV-infected children (61%; P < 0.001). Breastfeeding (odds ratio, 3.99; 95% CI: 1.92-8.27) and attending daycare (odds ratio, 3.42; 95% CI: 1.64-7.12) were independently associated with breakthrough infections. Genotype G1P[8] was detected more frequently in RotaTeq-vaccinated (44% versus 11%; P < 0.03) and G2P[4] in Rotarix-vaccinated children (42% versus 6%; P < 0.02). CONCLUSIONS:: RV vaccination protects young children effectively from RV disease and can reduce disease severity. Breastfeeding might impair VE, but further research is needed to identify the critical time window for this interference and to develop appropriate recommendations.
Cornelia Adlhoch; Marina Hoehne; Martina Littmann; Andreas Mas Marques; Almuth Lerche; Manuel Dehnert; Tim Eckmanns; Ole Wichmann; Judith Koch
Publication Detail:
Journal Detail:
Title:  The Pediatric infectious disease journal     Volume:  32     ISSN:  1532-0987     ISO Abbreviation:  Pediatr. Infect. Dis. J.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-1-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8701858     Medline TA:  Pediatr Infect Dis J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  e82-e89     Citation Subset:  -    
From the *Postgraduate Training for Applied Epidemiology, Robert Koch Institute, Berlin, Germany; †European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden; ‡Division of Molecular Epidemiology of Viral Pathogens, Robert Koch Institute, Berlin; §State Office for Public Health and Social Affairs, Mecklenburg-Western Pomerania, Rostock; ¶Department for Infectious Disease Epidemiology; ‖Surveillance Unit; and **Immunization Unit, Robert Koch Institute, Berlin, Germany.
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