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

摘要

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% Cl: 58-87) in low-mortality countries and 67% (95% Cl: 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.