Efficacy of live oral rotavirus vaccines by duration of follow-up: a meta-regression of randomised controlled trials
The Lancet Infectious Diseases·
- DOI
- 10.1016/s1473-3099(19)30126-4
- PMID
- 31178289
- PMCID
- PMC6595176
- OpenAlex
- W2948888508
- Study type
- Systematic review
- Publisher
- Elsevier BV
- Article type
- journal-article
- Integrity
- current
Why this research matters now
The findings suggest that rotavirus vaccine efficacy is lower and declines more steeply in high-mortality settings, though earlier disease onset in these settings may still allow for meaningful protection.
Structured evidence summary
Research question
The study aimed to estimate the efficacy of live oral rotavirus vaccines at different time points during follow-up and across settings with varying child mortality levels, using a synthesis of randomized controlled trial data.
Study design
This was a meta-regression study that analyzed all randomized controlled trials of rotavirus vaccines published through April 2018, identified via a Cochrane systematic review. A Bayesian hierarchical Poisson model was used to estimate pooled cumulative vaccine efficacy and waning over time for three mortality strata.
Population and setting
The analysis included infant vaccination schedules across multiple settings categorized by mortality stratum, excluding trials in special populations and those without infant schedules or adequate reporting of enrollment and case counts by follow-up period.
Main findings
In low-mortality settings (15 observations), instantaneous vaccine efficacy was 98% at 2 weeks and 94% at 12 months. In medium-mortality settings (11 observations), corresponding estimates were 82% and 77%. In high-mortality settings (24 observations), efficacy was 66% at 2 weeks and 44% at 12 months, with five different vaccines contributing data.
Public-health relevance
The findings suggest that rotavirus vaccine efficacy is lower and declines more steeply in high-mortality settings, though earlier disease onset in these settings may still allow for meaningful protection.
Important limitations
This summary is limited to the supplied single-article abstract and metadata; the original paper is required for decision-grade interpretation of potential biases, heterogeneity assessment, or additional methodological details not captured in the abstract.
GIDS interpretation
This study synthesizes published trial evidence on rotavirus vaccine performance over time and across settings; it does not constitute surveillance data or a live signal but rather a retrospective meta-analytic assessment of controlled trial outcomes.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 8 auditable classifier relationships to diseases, places, topics, and study design.