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Can Fam Physician. 2012 October; 58(10): 1081.
PMCID: PMC3470497

Canadian rotavirus vaccine effectiveness data

Stephen B. Lambert, MB BS PhD, Sarah L. Sheridan, MAppEpid, and Keith Grimwood, MB ChB MD

We read with interest and enjoyed Dr Goldman’s recent Child Health Update on the effectiveness of rotavirus vaccines.1

In Australia, there are 4 states currently using the multiple-strain vaccine (ie, RV5), and the remaining 2 states and 2 territories are using the single-strain vaccine (ie, RV1).2 Dr Goldman attributes our decline in rotavirus notifications and hospitalizations3 to RV1, but in Queensland we have always used RV5.4 Since mid-2007, we saw a rapid decline in rotavirus notifications in both vaccinated and older, unvaccinated age groups, and a fall in the proportion of laboratory tests positive for rotavirus in all age groups.5

Canada’s experience with rotavirus vaccines provides a wonderful opportunity to observe the effects of rotavirus vaccines, particularly in indigenous children living in harsh arctic and subarctic regions. In the pre-vaccine era in Queensland, we found rotavirus disproportionately affected aboriginal and Torres Strait Islander children with higher rates of notification and hospitalization, and hospitalization earlier in life with a longer average length of stay.6 Recent outbreak data from the Northern Territory, where RV1 has been used since late 2006, suggests effectiveness wanes rapidly after infancy in indigenous children.7 To date, we have no equivalent data from a state that uses RV5, but we are collating these data in Queensland. Of note, middle-income Latin American countries have seen blunted effectiveness values, compared with efficacy data, with both vaccines.8

We look forward to Canadian effectiveness data, particularly from Canada’s aboriginal population, as they become available to aid our understanding of rotavirus epidemiology in the vaccine era.

Footnotes

Competing interests

Dr Lambert has previously been a co-investigator on clinical trials sponsored by Merck, CSL, and GlaxoSmithKline—manufacturers or distributors of rotavirus vaccines in Australia. Merck paid an honorarium to his institute for 2 rotavirus presentations to international meetings. Dr Grimwood has, in the past 10 years, been a member of a Rotavirus Advisory Board and received support for conference attendance, lecture fees, and a research grant from GlaxoSmithKline. He has also received a research grant from Merck.

References

1. Goldman RD. Effectiveness of rotavirus vaccine in preventing severe acute gastroenteritis in children. Can Fam Physician. 2012;58:270–1. [PMC free article] [PubMed]
2. Buttery JP, Lambert SB, Grimwood K, Nissen MD, Field EJ, Macartney KK, et al. Reduction in rotavirus-associated acute gastroenteritis following introduction of rotavirus vaccine into Australia’s National Childhood vaccine schedule. Pediatr Infect Dis J. 2011;30(1 Suppl):S25–9. [PubMed]
3. Field EJ, Vally H, Grimwood K, Lambert SB. Pentavalent rotavirus vaccine and prevention of gastroenteritis hospitalizations in Australia. Pediatrics. 2010;126(3):e506–12. [PubMed]
4. Grimwood K, Lambert SB. Rotavirus vaccines: opportunities and challenges. Hum Vaccin. 2009;5(2):57–69. Epub 2009 Feb 8. [PubMed]
5. Lambert SB, Faux CE, Hall L, Birrell FA, Peterson KV, Selvey CE, et al. Early evidence for direct and indirect effects of the infant rotavirus vaccine program in Queensland. Med J Aust. 2009;191(3):157–60. [PubMed]
6. Campbell SJ, Nissen MD, Lambert SB. Rotavirus epidemiology in Queensland during the pre-vaccine era. Commun Dis Intell. 2009;33(2):204–8. [PubMed]
7. Snelling TL, Andrews RM, Kirkwood CD, Culvenor S, Carapetis JR. Case-control evaluation of the effectiveness of the G1P[8] human rotavirus vaccine during an outbreak of rotavirus G2P[4] infection in central Australia. Clin Infect Dis. 2011;52(2):191–9. [PubMed]
8. Sheridan S, Lambert S, Grimwood K. Impact of rotavirus vaccination on childhood gastroenteritis. Microbiol Aust. 2012;33(2):56–60.

Articles from Canadian Family Physician are provided here courtesy of College of Family Physicians of Canada