Post-licensure experience with rotavirus vaccination in Latin America and the Caribbean: a systematic review and meta-analysis

ABSTRACT

Introduction: Latin American countries were among the first to adopt rotavirus vaccines into national immunization programs; we reviewed one decade of their experience with rotavirus vaccination.

Areas covered: We systematically reviewed manuscripts published January 1990–January 2018 to assess rotavirus vaccine effectiveness (VE) via meta-analysis; describe trends in rotavirus and acute gastroenteritis (AGE)-associated hospitalizations and mortality before and after vaccine introduction; and estimate annual hospitalizations and deaths averted by rotavirus vaccination in Latin American and Caribbean children <5 years. Rotavirus vaccines demonstrated VE against rotavirus hospitalization of 76% (95% CI: 58–87) in low-mortality countries and 67% (95% CI: 54–76) in high-mortality countries for children <1 year of age. Reductions of 64.0% (interquartile range (IQR): 49.9–69.2) were observed in rotavirus hospitalizations, 32.8% (IQR 29.0–40.3) in AGE hospitalizations, and 53.5% (IQR: 40.4–57.1) in AGE-related mortalities in children <5 years. In 2015, an estimated 125,000 rotavirus-associated hospitalizations and 800 rotavirus-related deaths were prevented in countries that implemented rotavirus vaccines.

Expert Commentary: Rotavirus vaccines remain an effective tool against diarrheal disease. The continued success of rotavirus vaccines provides evidence for adoption in Latin American and Caribbean countries that have not yet introduced it, and improvement within those with low coverage.

KEYWORDS:

• Caribbean
• Latin America
• rotavirus
• Rotarix
• RotaTeq
• vaccine impact
• vaccine effectiveness

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Disclaimer

The findings and conclusions in this report are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention or the Pan American Health Organization.

Supplementary material

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Additional information

Funding

The manuscript was not funded.