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ROTAVIRUS VACCINE IMPACT: INDIRECT PROTECTION OF ADULTS FROM ROTAVIRUS BY PEDIATRIC ROTAVIRUS VACCINATION

Friday, 14th of June 2013

• INDIRECT PROTECTION OF ADULTS FROM ROTAVIRUS BY PEDIATRIC ROTAVIRUS VACCINATION

Clin Infect Dis. (2013) 56 (6): 755-760. doi: 10.1093/cid/cis1010 First published online: January 23, 2013

Evan J. Anderson et al.

Correspondence: Evan J. Anderson, MD, Division of Pediatric Infectious Diseases, Departments of Pediatrics and Medicine, Emory University School of Medicine, 2015 Uppergate Dr, Atlanta, GA 30322 (evanderson@emory.edu).

Presented in part: 49th Annual Meeting of the Infectious Diseases Society of America, Boston, MA, 20–23 October 2011.

Abstract below; full text available to journal subscribers

Background. Pediatric vaccination has resulted in declines in disease in unvaccinated individuals through decreasing pathogen circulation in the community. About 2 years after implementation of pediatric rotavirus vaccination in the United States, dramatic declines in rotavirus disease were observed in both vaccinated and unvaccinated children. Whether this protection extends to adults is unknown.

Methods. The prevalence of rotavirus, as determined by Rotaclone enzyme immunoassay, in adults who had stools submitted for bacterial stool culture (BSC) between February to May to Northwestern Memorial Hospital, Chicago, was compared between the prepediatric impact era (2006–2007) and the pediatric impact era (2008–2010). Isolates were genotyped and clinical characteristics of those with rotavirus were compared.

Results. Of the 5788 BSC sent, 4725 met inclusion criteria and 3530 of these (74.7%) were saved for rotavirus testing. The prevalence of rotavirus among adults who had stool sent for BSC declined from 4.35% in 2006–2007 to 2.24% in 2008–2010 (a relative decline of 48.4%; P = .0007). The decline in the prevalence of rotavirus was of similar significant magnitude in both outpatients and inpatients. Marked year-to-year variability was observed in circulating rotavirus genotypes, with strain G2P[4] accounting for 24%; G1P[8], 22%; G3P[8], 11%; and G12P[6], 10% overall. About 30% of adults from whom rotavirus was isolated were immunocompromised and this remained constant.

Conclusions. Pediatric rotavirus vaccination correlated with a relative decline of almost 50% in rotavirus identified from adult BSC during the peak rotavirus season, suggesting that pediatric rotavirus vaccination protects adults from rotavirus.