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Evaluation of the effectiveness of universal rotavirus vaccination on the reduction of rotavirus disease burden in Israel
Researchers: Khitam Muhsen1, Eias Kassem2, Uri Rubenstein3, Moshe Ephros4, Lester M. Shulman5, Dani Cohen11, Eias Kassem2, Uri Rubenstein33, Moshe Ephros4, Lester M. Shulman5, Dani Cohen1
- Tel-Aviv University
- Hillel Yaffe Medical Center
- Laniado Medical Cente
- Carmel Medical Center
- Ministry of Health
Background: Uncertainties exist regarding the sustainability of the reductions in in rotavirus gastroenteritis (RVGE) that followed the introduced rotavirus vaccines to national immunization programs, as well as potential impact on the circulating genotypes.
Objectives: We examined the changes in incidence rates of RVGE hospitalization and rotavirus genotypes, five-year after the introduction of RotaTeq into the national immunization program in Israel.
Method: Data were obtained prospectively on hospitalizations of children aged 0-59 months due to gastroenteritis (N=7,346) in three hospitals in northern Israel. Stool samples were tested for rotavirus by immunochromatography and genotyping (N=509) was determined by RT-PCR.
Findings: The average incidence rate of RVGE hospitalizations has declined by 58.5% (95% CI 46.4%-71.0%) from 5.6 per 1000 (95% CI 5.0-6.2) in the universal immunization period (2008-2010) to 2.3 per 1000 (95% CI 2.0-2.7) during the universal immunization era (2011-2015), and yearly fluctuations were still observed. The most common genotypes in the pre-universal immunization period were G1P[8] (35.4%), followed by G2P[4] (15.5%), G3P[8] (8.7%), G4P[8] (4.2%) and G9P[8] (4.2%). The dominance of G1P[8] was carried forward into the universal immunization period followed by G3P[8] (21.3%) G9P[8] (15.7%) and G12P[8] (4.6%), while mixed rotavirus infections were no longer detected.
Conclusions: Universal immunization with RoteTeq in Israel was followed by a sustained reduction in RVGE hospitalizations. It is not clear whether changes in the circulating rotavirus genotypes, were due to vaccine-induced selective pressure.
Recommendations: 1) The national immunization program with RotaTeq should be continued.
2) Assessment of the long-term impact of rotavirus vaccination on the incidence of rotavirus gastroenteritis and strain surveillance is warranted.
3) Our long-standing network could be instrumental.
4) Adding more centers might be needed for strain surveillance, given the reduced circulation of rotavirus in the population.
2) Assessment of the long-term impact of rotavirus vaccination on the incidence of rotavirus gastroenteritis and strain surveillance is warranted.
3) Our long-standing network could be instrumental.
4) Adding more centers might be needed for strain surveillance, given the reduced circulation of rotavirus in the population.
Research number: A/154/2011
Research end date: 12/2016