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Clinical and Vaccine Immunology, March 2009, p. 382-386, Vol. 16, No. 3
1071-412X/09/$08.00+0     doi:10.1128/CVI.00382-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Decline in Cases of Rotavirus Gastroenteritis Presenting to The Children's Hospital of Philadelphia after Introduction of a Pentavalent Rotavirus Vaccine{triangledown}

H Fred Clark,1* Diane Lawley,1 Laura A. Mallette,2 Mark J. DiNubile,3 and Richard L. Hodinka4

Division of Infectious Diseases, The Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania,1 Department of Vaccine and Biologics Research, Merck Research Laboratories, Wayne, Pennsylvania,2 Department of Medical Communications, Merck Research Laboratories, Upper Gwynedd, Pennsylvania,3 Division of Infectious Diseases and Clinical Virology Laboratory, Departments of Pediatrics and Pathology, The Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania4

Received 21 October 2008/ Returned for modification 18 November 2008/ Accepted 12 January 2009

A pentavalent rotavirus vaccine for infants became available in the United States in February 2006. By 2007, vaccination rates nationwide were estimated to be ~50%. We studied the effectiveness of the vaccine in a real-world setting outside of a clinical trial. All children presenting to The Children's Hospital of Philadelphia with acute gastroenteritis have been monitored for the presence of rotavirus antigen in the stool by enzyme-linked immunosorbent assay (ELISA [followed by genotyping if ELISA positive]) since the 1994-1995 epidemic season, presenting a unique opportunity to assess the impact of the recently introduced vaccine. The annual number of community-acquired cases over the preceding 13 years had approached or exceeded 100, with 271 cases in 2005 to 2006 and 167 cases in 2006 to 2007. In the 2007-2008 season, only 36 community-acquired cases were identified, representing an 87% reduction from the same period in 2005 to 2006. G3 was the predominant serotype, accounting for 15 community cases (42%). Our study is limited by its observational design using historical comparisons. Nonetheless, the abrupt decline in rotavirus gastroenteritis cases during the 2007-2008 season likely resulted from vaccination. Because protection rates appeared to have exceeded vaccination rates, herd immunity may have contributed to some degree to the effectiveness of the vaccine.

* Corresponding author. Mailing address: Division of Infectious Diseases, Abramson Research Center Room 1202, The Children's Hospital of Philadelphia, 3516 Civic Center Blvd., Philadelphia, PA 19104. Phone: (215) 590-2044. Fax: (215) 590-2025. E-mail: clarkf{at}email.chop.edu

{triangledown} Published ahead of print on 21 January 2009.

Clinical and Vaccine Immunology, March 2009, p. 382-386, Vol. 16, No. 3
1071-412X/09/$08.00+0     doi:10.1128/CVI.00382-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Danchin, M. H., Bines, J. E. (2009). Defeating Rotavirus? The Global Recommendation for Rotavirus Vaccination. NEJM 361: 1919-1921 [Full Text]  


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