Prevention of rotavirus gastroenteritis in infants and children: rotavirus vaccine safety, efficacy, and potential impact of vaccines

Figures & data

Table 1 Regional distribution of rotavirus serotypes

Serotype	Africa, %	Asia, %	Europe, %	North America, %	Oceania, %	South America, %
P[8]G1	23	34	72	73	82	34
P[4]G2	2	13	9	11	13	23
P[8]G3	21	1	2	6	1	2
P[8]G4	4	20	11	1	2	9
P[8]G9	5	5	3	1	1	15
P[6]G9	2	7	1	2	0	1
Other	16	6	1	1	0	5
Unusual	27	14	1	5	0	11

Note: Copyright © 2005. Adapted with permission from Santos N, Hoshino Y. Global distribution of rotavirus serotypes/genotypes and its implication for the development and implementation of an effective rotavirus vaccine. Rev Med Virol. 2005;15:29–56.

Figure 1 Comparison of vaccine efficacy and effectiveness estimations from clinical trials of RV1 and RV5 against any serotype severe rotavirus gastroenteritis, stratified by country income status.

^aThis study took place in a native population characterized by diarrheal pathogens that are similar to lower income settings.^{130 b}Although countries ranged from lower middle to high income, most study countries are from the upper middle income category.

Note: Efficacies and effectiveness estimates are taken from the following sources (from left to right): Asia,⁸⁶ USA,⁷⁰ Europe,⁷⁰ Europe,⁸⁵ Israel,¹²⁶ Finland,⁸⁴ Australia,⁹² USA,⁷⁵ Latin America,⁷⁰ Brazil,⁸⁹ Finland/Latin America,⁸³ South Africa,⁸⁷ El Salvador,⁹³ Nicaragua,⁷⁶ Sub-Saharan Africa and Southeast Asia,⁷¹ Malawi.⁸⁷

Figure 2 Estimated distribution of deaths caused by rotavirus diarrhea among children aged younger than 5 years.

Figure 3 Estimated incidence of deaths caused by rotavirus diarrhea per 100,000 children aged younger than 5 years.

Table 2 Deaths due to rotavirus in children aged younger than 5 years, stratified by national income stratum

Income classification^a	Total	Per 100,000 children younger than 5 y
High	413	0.6
Upper middle	5,330	6.9
Lower middle	191,264	53.4
Low	189,106	137.9
Total	386,113	209.7

Table 3 Deaths due to rotavirus in children aged younger than 5 years, stratified by region

World bank	Rotavirus deaths
Region	Total	Per 100,000 children younger than 5 y
Africa	236,519	155.8
Asia	144,095	39.6
Europe	167	0.4
Latin America and Caribbean	5,000	8.8
North America	3	0.0
Oceania	328	11.6

Figure 4 Total deaths prevented by rotavirus vaccine in children aged under 5 years if introduced at level of DTP-3.

Figure 5 Total deaths prevented by rotavirus vaccine per 100,000 children aged younger than 5 years if introduced at level of DTP-3.

Figure 6 Global status of routine introduction of rotavirus vaccination.

Table 4 Impact of rotavirus vaccines on diarrheal deaths if introduced at level of DTP-3, stratified by national income stratum

Income classificationa	Diarrheal deaths prevented		Proportion prevented
	Total	Per 100,000 children younger than 5 y	Rotavirus deaths, %	Diarrheal deaths, %
High	301	0.5	71	26
Upper middle	3,121	4.0	44	15
Lower middle	84,989	23.7	44	13
Low	77,417	56.5	41	12
Total	165,828	26.0	43	14

Note:

a World Bank 2008 classification. GNP per capita estimations from the US Government¹³¹ were used to approximate GNI for the Cook Islands, Nauru, Niue, and Tuvalu.

Table 5 Impact of rotavirus vaccines on diarrheal deaths if introduced at level of DTP-3, stratified by regiona

World Bank Region	Diarrheal deaths prevented		Proportion prevented
	Total	Per 100,000 children aged younger than 5 years	Rotavirus deaths, %	Diarrheal deaths, %
Africa	95,623	63.0	40	12
Asia	67,803	18.6	47	14
Europe	136	0.4	80	31
Latin America and Caribbean	2,145	3.8	31	11
Oceania	121	4.3	37	15

Note:

a North America has not been included because rotavirus vaccines were already reaching 88% of the children in the region.

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