Rotavirus Vaccine Studied in Nicaraguan Children

Vaccine not as effective as previous trials conducted in developed countries
By A. Agrawal, PhD
HealthDay Reporter

WEDNESDAY, June 3 (HealthDay News) -- The pentavalent rotavirus vaccine (RV5) is effective in preventing severe rotavirus diarrhea in Nicaraguan children, though to a lesser extent compared with previous trials conducted in developed countries, according to a study in the June 3 issue of the Journal of the American Medical Association.

Manish Patel, M.D., from the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues examined the association between RV5 vaccination and rotavirus diarrhea requiring hospitalization or intravenous hydration in 285 children who were hospitalized or required intravenous hydration for confirmed rotavirus diarrhea (cases) and 840 neighborhood and 690 hospital children (controls) in Nicaragua.

The researchers found that receiving three doses of the vaccine was associated with a lower risk of rotavirus diarrhea requiring hospitalization or intravenous hydration (odds ratio, 0.54). Vaccination was associated with a lower risk of severe (odds ratio, 0.42) and very severe (odds ratio, 0.23) rotavirus diarrhea. The vaccine effectiveness was 46 percent against rotavirus diarrhea requiring hospitalization or intravenous hydration, 58 percent against severe diarrhea, and 77 percent against very severe diarrhea, compared with 85 to 98 percent against severe diarrhea in previous trials conducted in middle- and high-income countries.

"In summary, RV5 was associated with lower odds of severe rotavirus diarrhea in Nicaragua but to a lesser extent than observed during the clinical trial in industrialized countries," Patel and colleagues conclude. "Our study period coincided with a season when G2P[4], a less common rotavirus strain, predominated."

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