The impact of the recommendation of routine rotavirus vaccination in Germany: An interrupted time-series analysis期刊界 All Journals 搜尽天下杂志传播学术成果专业期刊搜索期刊信息化学术搜索

The impact of the recommendation of routine rotavirus vaccination in Germany: An interrupted time-series analysis

Affiliation:	1. Department of Pediatric Surgery, Besançon University Hospital, F-25000 Besançon, France;2. INSERM-CIC-1431, Besançon University Hospital, F-25000 Besançon, France;3. Phisquare Institute, Transplantation Foundation, F-75015 Paris, France;4. INSERM UMR 1181 « Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases » (B2PHI), F-75015 Paris, France;5. Institut Pasteur, UMR 1181, B2PHI, F-75015 Paris, France;6. University of Versailles St Quentin, UMR 1181, B2PHI, F-78180 Montigny-le-Bretonneux, France;7. AP-HP, Raymond Poincare Hospital, F-92380 Garches, France;1. Sun Yat-sen University Zhongshan School of Medicine, Key Laboratory of Tropical Disease Control (Sun Yat-Sen University), Ministry of Education, Guangzhou 510080, China;2. The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China;1. National Pediatric Hospital, Ministry of Health, Phnom Penh, Cambodia;2. National Immunization Program, Ministry of Health, Phnom Penh, Cambodia;3. Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, USA;4. Global Immunization Division, Centers for Disease Control & Prevention, Atlanta, USA;5. Expanded Programme on Immunization, Western Pacific Regional Office, Manila, Philippines;6. Expanded Programme on Immunization, World Health Organization, Phnom Penh, Cambodia;1. Department of Microbiology and Center of Infectious Diseases, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China;2. Department of Infectious Diseases, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China;3. Department of Major Projects, Zhengzhou Municipal Center for Disease Control and Prevention, Zhengzhou 450053, China;4. Shenzhen Kangtai Biological Products Co., Ltd, Shenzhen 518057, China;1. Unidad de de Investigación Médica en Inmunología, UMAE Hospital de Pediatría, Centro Médico Nacional “Siglo XXI”, Instituto Mexicano del Seguro Social, Ciudad de México, Mexico;2. Posgrado en Ciencias Biológicas, Universidad Nacional Autónoma de México, Ciudad de México, Mexico;3. Unidad de Investigación en Enfermedades Infecciosas y Parasitarias, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, Mexico

Abstract:	BackgroundRotavirus is a highly contagious virus causing gastroenteritis, mostly in children under the age of 5. Since 2006, two vaccines are available in Germany. In 2013, these were included into the German national vaccination schedule. The aim of this intervention is to reduce the incidence and hospitalization among children under 5 years caused by rotavirus. The effectiveness of the intervention was analyzed in this study.MethodsNational surveillance data of laboratory confirmed rotavirus infections among children under the age of 5 were analyzed using interrupted time-series analysis. Weekly incidence from 2011 to 2017 and monthly hospital discharge rates from 2005 to 2015 were analyzed using a segmented generalized linear model with Poisson distribution.ResultsAfter adjusting for seasonal effects the incidence were approximately 22% (95% CI: 13.2–30.1) lower than expected following the intervention. The hospitalizations were approximately 27% (95% CI: 14.9–39.7) lower than expected following the intervention. The long-term effects of the intervention were nearly zero. The incidence changed in trend by −0.2% (95% CI: −0.1 to (−0.3)) and the hospitalizations by +0.2% (95% CI: 1.2–(−0.8)) following the intervention.ConclusionAfter the inclusion of the vaccines into the national vaccination schedule significant immediate effects of this intervention were found. The weekly incidences and monthly hospitalization caused by the rotavirus were more than 20% lower than expected. The long-term effects of the intervention however were found to be nearly zero. This could be caused by a low vaccination rate in the German population.

Keywords:	Rotavirus Rotavirus vaccine Interrupted time-series analysis Intervention effectiveness Segmented regression Impact Incidence Hospitalization Surveillance Quasi-experimental research design
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