Effect of Rotavirus Vaccination on Diarrhea Outcomes among Children Younger Than 5 Years
The Pediatric Infectious Disease Journal:
Take Home Message:
Diarrheal disease is a leading cause of childhood morbidity and mortality globally. Rotavirus is the leading cause of vaccine-preventable diarrhea among children under 5 and is associated with approximately 28% of diarrheal deaths. The highest burden of severe disease and deaths due to rotavirus infections occurs in low-income countries.
In countries without rotavirus vaccination, nearly all children become infected with rotavirus during the first few years of life, regardless of hygiene or sanitation facilities or whether they live in high-income or resource-poor settings.
World Health Organization recommends the inclusion of rotavirus vaccination in all national immunization programs.
The results of this systematic review confirm the protective efficacy and effectiveness of rotavirus vaccination against rotavirus and all diarrheal outcomes among children under 5 globally.
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Background:
Rotavirus is the leading cause of vaccine-preventable diarrhea among children under 5 globally. Rotavirus vaccination has been shown to prevent severe rotavirus infections with varying efficacy and effectiveness by region.
Methods:
We sought to generate updated region-specific estimates of rotavirus vaccine efficacy and effectiveness. We systematically reviewed published vaccine efficacy and effectiveness studies to assess the region-specific effect of rotavirus vaccination on select diarrheal morbidity and mortality outcomes in children under 5 years of age. We employed meta-analytic methods to generate pooled effect sizes by Millennium Development Goal region.
Results:
Rotavirus vaccination was both efficacious and effective in preventing rotavirus diarrhea, severe rotavirus diarrhea and rotavirus hospitalizations among children under 5 across all regions represented by the 48 included studies. Efficacy against severe rotavirus diarrhea ranged from 90.6% in the developed region to 88.4% in Eastern/Southeastern Asia, 79.6% in Latin America and the Caribbean, 50.0% in Southern Asia and 46.1% in sub-Saharan Africa. Region-specific effectiveness followed a similar pattern. There was also evidence of vaccine efficacy against severe diarrhea and diarrheal hospitalizations.
Conclusion:
Our findings confirm the protective efficacy and effectiveness of rotavirus vaccination against rotavirus diarrheal outcomes among children under 5 globally.
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