Impact of rotavirus vaccination on childhood deaths from diarrhea in Brazil

https://doi.org/10.1016/j.ijid.2010.11.007Get rights and content
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Summary

Objectives

Rotavirus vaccination was introduced in Brazil in March 2006, targeting an annual birth cohort of approximately 3.5 million. We analyzed trends in all-cause gastroenteritis-related deaths in children <5 years of age during the pre- and post-vaccination periods.

Methods

Data from the National Immunization Program and the Mortality Information System were used to calculate vaccine coverage and mortality rates related to gastroenteritis in children <1 year and 1–4 years of age, using population estimates from the census as the denominator. Relative reductions in mortality rates were calculated for 2007 and 2008, using the 2004–2005 mean as baseline before vaccine introduction.

Results

Coverage of two doses of human rotavirus vaccine was 39% in 2006, increasing to 72% in 2007 and 77% in 2008. During 2004–2005, the gastroenteritis mortality rate in children <1 year of age was 56.9 per 100 000, decreasing by 30% (95% confidence interval (CI) 19–41) in 2007 and by 39% (95% CI 29–49) in 2008. In children 1–4 years of age, the mortality rate was 4.5 per 100 000 during 2004–2005, decreasing by 29% (95% CI 10–49) in 2007 and by 33% (95% CI 15–52) in 2008.

Conclusions

The decreased rates of childhood gastroenteritis-related deaths in Brazil following rotavirus vaccine introduction, particularly among children <1 year of age, suggest the potential benefit of vaccination.

Keywords

Gastroenteritis
Rotavirus
Mortality
Human rotavirus vaccine
Brazil

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