Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jun 1;72(11):2000-2005.
doi: 10.1093/cid/ciaa466.

Rotavirus Vaccine Is Effective Against Rotavirus Gastroenteritis Resulting in Outpatient Care: Results From the Medically Attended Acute Gastroenteritis (MAAGE) Study

Affiliations

Rotavirus Vaccine Is Effective Against Rotavirus Gastroenteritis Resulting in Outpatient Care: Results From the Medically Attended Acute Gastroenteritis (MAAGE) Study

Rachel M Burke et al. Clin Infect Dis. .

Abstract

Background: Rotavirus is a common cause of severe pediatric acute gastroenteritis. Two vaccines are licensed in the United States and have demonstrated high effectiveness against moderate to severe disease. However, fewer data are available on rotavirus vaccine effectiveness (VE) against milder disease.

Methods: We leveraged active surveillance data from Kaiser Permanente Northwest to calculate rotavirus VE against medically attended rotavirus illness among age-eligible children. We utilized a test-negative case-control design and applied 4 distinct case definitions based on reverse transcription-quantitative real-time PCR (qRT-PCR) assay and enzyme immunoassay (EIA) test results. VE was calculated as 100 × (1 - odds ratio), and models were adjusted for age group.

Results: The VE analysis population comprised 842 children, 799 (95%) of whom had mild disease requiring at most a clinic visit and 698 (83%) of whom were fully vaccinated against rotavirus. Age-adjusted VE was 70% (95% confidence interval [CI], 37-86%) against disease defined solely by qRT-PCR results, 72% (95% CI, 31-89%) against disease as defined by qRT-PCR with a quantification cycle (C q ) value <27, 73% (95% CI, 32-90%) against disease that was qRT-PCR positive but EIA negative, and 62% (95% CI, -20-88%) against disease defined solely by EIA. Results were similar when restricting to disease resulting in at most an ambulatory clinic or emergency department visit.

Conclusions: These results support the effectiveness of rotavirus vaccination in protecting US children from mild to moderate and severe disease. Our findings are also useful to show the effectiveness of rotavirus vaccination against qRT-PCR-defined illness.

Keywords: pediatric gastroenteritis; rotavirus; rotavirus vaccine effectiveness; vaccine effectiveness.

PubMed Disclaimer

Conflict of interest statement

Potential conflicts of interest. M. S. received institutional research funding to the Kaiser Permanente Center for Health Research for the MAAGE project from the CDC Foundation and through investigator-initiated research grants from Takeda Vaccines, Inc. A. L. N. received research grants from Pfizer for an unrelated project. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Similar articles

Cited by

References

    1. Cortese MM, Parashar UD; Centers for Disease Control and Prevention. Prevention of rotavirus gastroenteritis among infants and children: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2009; 58:1–25. - PubMed
    1. Pindyck T, Tate JE, Parashar UD. A decade of experience with rotavirus vaccination in the United States—vaccine uptake, effectiveness, and impact. Expert Rev Vaccines 2018; 17:593–606. - PMC - PubMed
    1. Shah MP, Tate JE, Steiner CA, Parashar UD. Decline in emergency department visits for acute gastroenteritis among children in 10 US states after implementation of rotavirus vaccination, 2003 to 2013. Pediatr Infect Dis J 2016; 35:782–6. - PMC - PubMed
    1. Krishnarajah G, Demissie K, Lefebvre P, Gaur S, Sheng Duh M. Clinical and cost burden of rotavirus infection before and after introduction of rotavirus vaccines among commercially and Medicaid insured children in the United States. Hum Vaccin Immunother 2014; 10:2255–66. - PMC - PubMed
    1. Schmidt MA, Groom HC, Naleway AL, et al. A model for rapid, active surveillance for medically-attended acute gastroenteritis within an integrated health care delivery system. PLoS One 2018; 13:e0201805. - PMC - PubMed

Publication types