Assessing the effectiveness and public health Impact of one dose of rotavirus vaccine in developing countries like Pakistan

Introduction of rotavirus vaccine has resulted in a decrease in prevalence of rotavirus in the United States in previous years. In third world countries, like Pakistan, diarrhea remains a major cause of infant mortality and morbidity. Based on US studies' data, even one dose of vaccine is better than complete course. A single dose of vaccine to children in a third world country can reduce rotavirus cases significantly. METHODS: This study involved: (1) Case control study of children with rota tests (Dec-June 2006, 2007, 2008) from 2 pediatric hospitals (2) active surveillance of children with acute gastroenteritis symptoms during Dec.-June 2010, 2011 from 3 pediatric hospitals. Vaccinations received were collected from state immunization registry. We examined the association between vaccine status (receiving only 1 dose of Rotarix or Rotateq vs. no vaccine) and contracting rotavirus for each season. RESULTS: We detected significant association between vaccine group (1 dose vs. none) and contracting rotavirus for seasons 1, 3, and 5. Overall, for children receiving only 1 dose of either vaccine, the odds of contracting rotavirus was significantly less when compared to children who received neither vaccine (OR = 0.22, 95% CI [0.11 – 0.44], p-value < 0.001). We also noticed a change in the proportion of children vaccinated (received at least 1 vaccine) (20%, 42%, 37%, 65%, 64%, p < 0.001). CONCLUSION: Receiving only one dose of the Rotarix or Rotateq vaccine reduces a child's risk for contracting rotavirus. Furthermore, there appears to be an increasing trend in vaccine use.