Rotavirus vaccination in all areas of Brazil is associated with reduced diarrhea-related deaths and hospital admissions in children aged under five years, reports a study in this week's PLoS Medicine.
Manish Patel from the Centers for Disease Control and Prevention in Atlanta, Georgia, USA, and colleagues show that these real-world impact data—what actually happens in reality rather than in strictly controlled clinical trial settings—are consistent with the clinical trials and conclude that their study strengthens the evidence base for use of rotavirus vaccination as an effective measure for controlling severe and fatal childhood diarrhea.
Brazil has a high incidence of diarrhea-related deaths and hospital admissions in young children and, in July 2006, the Brazilian Ministry of Health introduced rotavirus vaccination simultaneously in all 27 states, allowing the authors to conduct a ''before'' and ''after'' intervention analysis.
Furthermore, the largest reductions in deaths and admissions were among children who had the highest rates of vaccination (less than two years of age), and the lowest reductions were among children who were not age-eligible for vaccination during the study period (aged 2 years).
The authors say: "This time-series analysis provides evidence of substantial reductions following the introduction of rotavirus vaccination of both diarrhea-related deaths and diarrhea-related hospital admissions from a large middle-income country in the Americas with both developing and developed regions."
They continue: "In middle-income countries that are not eligible for financial support from donors, the potential reductions in diarrhea-related hospital admissions and other health-care costs will be important for cost-effectiveness considerations to justify the purchase of these relatively expensive vaccines."