Peer-reviewed article
Low uptake rotavirus vaccine: A study of vaccine effectiveness against rotavirus-related hospitalization based on electronic health records, Slovenia, 2019-2023.
Maja Mrzel, Kostas Danis, Veronika Učakar ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study evaluated how well rotavirus vaccines protect children in Slovenia from severe rotavirus infection requiring hospitalization. Researchers analyzed vaccination records and hospital data for nearly 90,000 children born between 2019 and 2023. They found that fully vaccinated children had 84% protection against rotavirus hospitalization, and even partially vaccinated children had 81% protection. The vaccines remained highly effective across different age groups and through 5 years of age.
Key points
- Vaccine effectiveness against rotavirus hospitalization was 84% (95% CI: 73%-91%) for fully vaccinated children and 81% (95% CI: 42%-94%) for partially vaccinated children
- 94% of rotavirus hospitalizations occurred among unvaccinated children
- Effectiveness was 85% for Rotarix (RV1) and 78% for RotaTeq (RV5)
- Protection remained high across age groups: 73% in children under 11 months and 88% in children aged 11-23 months, sustained through age 5
- A negative correlation was observed between vaccination coverage and hospitalization rates across municipalities (r = -0.155, p = 0.024)
Limitations
The study was conducted in Slovenia where vaccine uptake was already quite low (only 25% fully vaccinated), which may limit generalizability to settings with higher coverage. The observational design using electronic health records cannot establish causation with complete certainty, though quasi-Poisson regression was used to adjust for confounding factors.
Abstract
BACKGROUND: In Slovenia, coverage of rotavirus vaccines (Rotarix (RV1) and RotaTeq (RV5)) remains low, and the vaccines are not included in the National Vaccination Programme (NVP). We aimed to estimate vaccine effectiveness (VE) against rotavirus-related hospitalization among children aged 6 weeks to 5 years to inform national vaccination policy. METHODS: We linked Slovenian population registry with vaccination, surveillance, and hospitalization databases for 2019-2023 birth cohorts. We defined fully vaccinated as those receiving all recommended doses with the last dose ≥14 days before the end date (disease onset or hospitalization date, death, or study end) and partially vaccinated those receiving ≥1 dose ≥14 days before the end date. We estimated VE using quasi-Poisson regression, adjusting for age, healthcare access, socioeconomic status, and calendar time, with person-time at risk included as an offset. We also examined the relationship between full vaccination coverage and hospitalization rates across municipalities using Pearson's correlation coefficient. RESULTS: Among 89,994 children, 4% were partially, and 25% fully vaccinated. A total of 1272 rotavirus hospitalizations occurred, 94% among unvaccinated children. VE against hospitalization was 84% (95% CI: 73%-91%) for full and 81% (95% CI: 42%-94%) for partial vaccination. VE was 85% (95% CI: 74%-91%) for RV1 and 78% (95% CI: -29%-96%) for RV5. VE was 73% (95% CI: 30%-89%) among children aged <11 months and 88% (95% CI: 76%-94%) among those aged 11 to 23 months, with sustained high effectiveness through 5 years of age (84%, 95% CI: 63%-93%). We observed a negative correlation between full vaccination coverage and hospitalization rates across municipalities (r = -0.155, p = 0.024). CONCLUSION: Both full and partial rotavirus vaccination significantly reduced rotavirus-related hospitalizations among children in Slovenia. These findings support efforts to improve vaccine uptake and consideration of rotavirus vaccination inclusion in the NVP to reduce disease burden.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Rotavirus vaccination (Rotarix RV1 or RotaTeq RV5) with full vaccination requiring all recommended doses
- Population
- Children aged 6 weeks to 5 years in Slovenia, birth cohorts 2019-2023 (n=89,994); 4% partially vaccinated, 25% fully vaccinated
Key finding
Full vaccination effectiveness: 84% (95% CI: 73%-91%) against hospitalization