Efficacy of live oral rotavirus vaccines by duration of follow-up: a meta-regression of randomised controlled trials.
Andrew Clark,Kevin van Zandvoort,Stefan Flasche,Colin Sanderson,Julie E Bines,Julie E Bines,Jacqueline E. Tate,Umesh D. Parashar,Mark Jit,Mark Jit +9 more
Reads0
Chats0
TLDR
Rotavirus vaccine efficacy is lower and wanes more rapidly in high-m mortality settings than in low-mortality settings, but the earlier peak age of disease in high/low mortality settings means that live oral rotavirus vaccines are still likely to provide substantial benefit.Abstract:
Summary Background The duration of protection offered by rotavirus vaccines varies across the world, and this variation is important to understanding and predicting the effects of the vaccines. There is now a large body of evidence on the efficacy of live oral rotavirus vaccines in different settings, but these data have never been synthesised to obtain robust estimates of efficacy by duration of follow-up. Our aim is to estimate the efficacy of live oral rotavirus vaccines at each point during follow-up and by mortality stratum. Methods In our meta-regression study, we identified all randomised controlled trials of rotavirus vaccines published until April 4, 2018, using the results of a Cochrane systematic review, and cross checked these studies against those identified by another systematic review. We excluded trials that were based on special populations, trials without an infant schedule, and trials without clear reporting of numbers of enrolled infants and events in different periods of follow-up. For all reported periods of follow-up, we extracted the mean duration of follow-up (time since administration of the final dose of rotavirus vaccination), the number of enrolled infants, and case counts for rotavirus-positive severe gastroenteritis in both non-vaccinated and vaccinated groups. We used a Bayesian hierarchical Poisson meta-regression model to estimate the pooled cumulative vaccine efficacy (VE) and its waning with time for three mortality strata. We then converted these VE estimates into instantaneous VE (iVE). Findings In settings with low mortality (15 observations), iVE pooled for infant schedules of Rotarix and RotaTeq was 98% (95% credibility interval 93–100) 2 weeks following the final dose of vaccination and 94% (87–98) after 12 months. In medium-mortality settings (11 observations), equivalent estimates were 82% (74–92) after 2 weeks and 77% (67–84) after 12 months. In settings with high mortality (24 observations), there were five different vaccines with observation points for infant schedules. The pooled iVE was 66% (48–81) after 2 weeks of follow-up and 44% (27–59) after 12 months. Interpretation Rotavirus vaccine efficacy is lower and wanes more rapidly in high-mortality settings than in low-mortality settings, but the earlier peak age of disease in high-mortality settings means that live oral rotavirus vaccines are still likely to provide substantial benefit. Funding Bill & Melinda Gates Foundation.read more
Citations
More filters
Reference EntryDOI
Vaccines for preventing rotavirus diarrhoea: vaccines in use
Karla Soares-Weiser,Harriet MacLehose,Hanna Bergman,Irit Ben-Aharon,Sukrti Nagpal,Elad Goldberg,Femi Pitan,Nigel A. Cunliffe +7 more
TL;DR: Evaluating rotavirus vaccines approved for use (RV1, RV5, and LLR) for preventingRotavirus diarrhoea in children with high-mortality rates found that RV1 probably prevents 40% of severe all-cause diarrhoeA episodes, and RV5probably prevents 40%, based on one large multicentre trial in Latin America and Finland.
Journal ArticleDOI
Immunization: vital progress, unfinished agenda
Peter Piot,Heidi J. Larson,Heidi J. Larson,Heidi J. Larson,Katherine L. O’Brien,John N. Nkengasong,Edmond S. W. Ng,Samba O. Sow,Beate Kampmann +8 more
TL;DR: It is shown that national and sub-national coverage of vaccination varies greatly and major unmet needs persist, suggesting that immunization is one of the best investments in health and should remain a priority for research, industry, public health and society.
Journal ArticleDOI
Real-world effectiveness of rotavirus vaccines, 2006-19: a literature review and meta-analysis.
TL;DR: Rotavirus vaccines were effective in preventing rotavirus diarrhoea, with higher performance in countries with lower child mortality, and non-product-specific vaccination was similar for Rotarix and RotaTeq mixed series.
Journal ArticleDOI
A comprehensive analysis of the efficacy and safety of COVID-19 vaccines.
Changjing Cai,Yinghui Peng,Edward Shen,Qiaoqiao Huang,Yihong Chen,Ping Liu,Cao Guo,Ziyang Feng,Le Gao,Xiangyang Zhang,Yan Gao,Yihan Liu,Ying Han,Ying Han,Shan Zeng,Hong Shen +15 more
TL;DR: In this article, the authors performed a comprehensive analysis of the published trials of COVID-19 vaccines and the real-world data from the Vaccine Adverse Event Reporting System.
Journal ArticleDOI
Modulation of immune responses to vaccination by the microbiota: implications and potential mechanisms
TL;DR: In this paper, the authors synthesize this evidence, discuss the immunological mechanisms that potentially mediate these effects and consider the potential of microbiota-targeted interventions to optimize vaccine effectiveness.
References
More filters
Journal ArticleDOI
Safety and Efficacy of a Pentavalent Human–Bovine (WC3) Reassortant Rotavirus Vaccine
Timo Vesikari,David O. Matson,Penelope H. Dennehy,Pierre Van Damme,Mathuram Santosham,Zoe M. Rodriguez,Michael J. Dallas,Joseph F. Heyse,Michelle G. Goveia,Steven Black,Henry R. Shinefield,Celia D. C. Christie,Samuli Ylitalo,Robbin F. Itzler,Michele L. Coia,Matthew T. Onorato,Ben A. Adeyi,Gary S. Marshall,Leif Gothefors,Dirk Campens,Aino Karvonen,James P. Watt,Katherine L. O'Brien,Mark J. DiNubile,H Fred Clark,John W. Boslego,Paul A. Offit,Penny M. Heaton +27 more
TL;DR: This vaccine was efficacious in preventing rotavirus gastroenteritis, decreasing severe disease and health care contacts, and the risk of intussusception was similar in vaccine and placebo recipients.
Journal ArticleDOI
Safety and Efficacy of an Attenuated Vaccine against Severe Rotavirus Gastroenteritis
Guillermo M. Ruiz-Palacios,Irene Pérez-Schael,F. Raúl Velázquez,Hector Abate,Thomas Breuer,Sue Ann Costa Clemens,Brigitte Cheuvart,Felix Espinoza,Paul Gillard,Bruce L. Innis,Yolanda Cervantes,Alexandre da Costa Linhares,Pio Lopez,Mercedes Macias-Parra,Eduardo Ortega-Barria,Vesta Richardson,Doris Maribel Rivera-Medina,Luis Rivera,Belén Salinas,Noris Pavía-Ruz,Jorge Salmerón,Ricardo Rüttimann,Juan Carlos Tinoco,Pilar Rubio,Ernesto Nuñez,M. Lourdes Guerrero,Juan Pablo Yarzabal,Silvia Damaso,Nadia Tornieporth,Xavier Sáez-Llorens,Rodrigo Vergara,Timo Vesikari,Alain Bouckenooghe,Ralf Clemens,Beatrice De Vos,Miguel O'Ryan +35 more
TL;DR: Two oral doses of the live attenuated G1P[8] HRV vaccine were highly efficacious in protecting infants against severe rotavirus gastroenteritis, significantly reduced the rate of severe gastroenteropathy from any cause, and were not associated with an increased risk of intussusception.
Journal ArticleDOI
Estimates of global, regional, and national morbidity, mortality, and aetiologies of diarrhoeal diseases: a systematic analysis for the Global Burden of Disease Study 2015
Christopher Troeger,Mohammad H. Forouzanfar,Puja C Rao,Ibrahim A Khalil,Alexandria Brown,Robert C. Reiner,Nancy Fullman,Robert L. Thompson,Amanuel Alemu Abajobir,Muktar Beshir Ahmed,Mulubirhan Assefa Alemayohu,Nelson Alvis-Guzman,Azmeraw T. Amare,Carl Abelardo T. Antonio,Hamid Asayesh,Euripide Frinel G Arthur Avokpaho,Ashish Awasthi,Umar Bacha,Aleksandra Barac,Balem Demtsu Betsue,Addisu Shunu Beyene,Dube Jara Boneya,Deborah Carvalho Malta,Lalit Dandona,Rakhi Dandona,Manisha Dubey,Babak Eshrati,Joseph R Fitchett,Tsegaye Tewelde Gebrehiwot,Gessessew Buggsa Hailu,Masako Horino,Peter J. Hotez,Tariku Jibat,Jost B. Jonas,Amir Kasaeian,Niranjan Kissoon,Karen L. Kotloff,Ai Koyanagi,G Anil Kumar,Rajesh Kumar Rai,Aparna Lal,Hassan Magdy Abd El Razek,Mubarek Abera Mengistie,Christine L. Moe,George C Patton,James A Platts-Mills,Mostafa Qorbani,Usha Ram,Hirbo Shore Roba,Juan Sanabria,Benn Sartorius,Monika Sawhney,Mika Shigematsu,Chandrashekhar T Sreeramareddy,Soumya Swaminathan,Bemnet Amare Tedla,Roman Topor Madry Jagiellonian,Kingsley N. Ukwaja,Andrea Werdecker,Marc-Alain Widdowson,Naohiro Yonemoto,Maysaa El Sayed Zaki,Stephen S Lim,Mohsen Naghavi,Theo Vos,Simon I. Hay,Christopher J L Murray,Ali H. Mokdad +67 more
TL;DR: Diarrhoea remains a largely preventable disease and cause of death, and continued efforts to improve access to safe water, sanitation, and childhood nutrition will be important in reducing the global burden of diarrhoeal disease.
Journal ArticleDOI
Rotavirus Infection in Infants as Protection against Subsequent Infections
F R Velázquez,David O. Matson,Juan J. Calva,Guerrero L,Ardythe L. Morrow,S Carter-Campbell,Roger I. Glass,Mary K. Estes,Larry K. Pickering,Guillermo M. Ruiz-Palacios +9 more
TL;DR: In infants, natural rotavirus infection confers protection against subsequent infection, which increases with each new infection and reduces the severity of the diarrhea.
Journal ArticleDOI
Global, Regional, and National Estimates of Rotavirus Mortality in Children <5 Years of Age, 2000-2013.
TL;DR: While rotvirus vaccine had been introduced in >60 countries worldwide by the end of 2013, the majority of countries using rotavirus vaccine during the review period were low-mortality countries and the impact of rotav virus vaccine on global estimates of rotovirus mortality has been limited.
Related Papers (5)
Efficacy of a monovalent human-bovine (116E) rotavirus vaccine in Indian infants: a randomised, double-blind, placebo-controlled trial.
Nita Bhandari,Temsunaro Rongsen-Chandola,Ashish Bavdekar,Jacob John,Kalpana Antony,Sunita Taneja,Nidhi Goyal,Anand Kawade,Gagandeep Kang,Sudeep Singh Rathore,Sanjay Juvekar,Jayaprakash Muliyil,Alok Arya,Hanif Shaikh,Vinod Joseph Abraham,Sudhanshu Vrati,Michael A. Proschan,Robert Kohberger,Georges Thiry,Roger I. Glass,Harry B. Greenberg,George Curlin,Krishna Mohan,G.V.J.A. Harshavardhan,Sai Prasad,T.S. Rao,John W. Boslego,Maharaj K. Bhan +27 more
Efficacy of pentavalent rotavirus vaccine against severe rotavirus gastroenteritis in infants in developing countries in Asia: a randomised, double-blind, placebo-controlled trial
George Armah,Samba O. Sow,Robert F. Breiman,Robert F. Breiman,Michael J. Dallas,Milagritos D. Tapia,Daniel R. Feikin,Daniel R. Feikin,Fred Binka,A. Duncan Steele,Kayla F. Laserson,Kayla F. Laserson,Nana Akosua Ansah,Myron M. Levine,Kristen D.C. Lewis,Michele L. Coia,Margaret Attah-Poku,Joel Ojwando,Joel Ojwando,Stephen B. Rivers,John C. Victor,Geoffrey Nyambane,Geoffrey Nyambane,Abraham Hodgson,Florian Schödel,Max Ciarlet,Kathleen M. Neuzil +26 more
Safety and Efficacy of a Pentavalent Human–Bovine (WC3) Reassortant Rotavirus Vaccine
Timo Vesikari,David O. Matson,Penelope H. Dennehy,Pierre Van Damme,Mathuram Santosham,Zoe M. Rodriguez,Michael J. Dallas,Joseph F. Heyse,Michelle G. Goveia,Steven Black,Henry R. Shinefield,Celia D. C. Christie,Samuli Ylitalo,Robbin F. Itzler,Michele L. Coia,Matthew T. Onorato,Ben A. Adeyi,Gary S. Marshall,Leif Gothefors,Dirk Campens,Aino Karvonen,James P. Watt,Katherine L. O'Brien,Mark J. DiNubile,H Fred Clark,John W. Boslego,Paul A. Offit,Penny M. Heaton +27 more
Safety and Efficacy of an Attenuated Vaccine against Severe Rotavirus Gastroenteritis
Guillermo M. Ruiz-Palacios,Irene Pérez-Schael,F. Raúl Velázquez,Hector Abate,Thomas Breuer,Sue Ann Costa Clemens,Brigitte Cheuvart,Felix Espinoza,Paul Gillard,Bruce L. Innis,Yolanda Cervantes,Alexandre da Costa Linhares,Pio Lopez,Mercedes Macias-Parra,Eduardo Ortega-Barria,Vesta Richardson,Doris Maribel Rivera-Medina,Luis Rivera,Belén Salinas,Noris Pavía-Ruz,Jorge Salmerón,Ricardo Rüttimann,Juan Carlos Tinoco,Pilar Rubio,Ernesto Nuñez,M. Lourdes Guerrero,Juan Pablo Yarzabal,Silvia Damaso,Nadia Tornieporth,Xavier Sáez-Llorens,Rodrigo Vergara,Timo Vesikari,Alain Bouckenooghe,Ralf Clemens,Beatrice De Vos,Miguel O'Ryan +35 more