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We compared rotavirus prevalence in diarrheal stool and hospitalization incidence before and following rotavirus vaccine introduction in Malawi. Using case-control analysis, we derived vaccine effectiveness VE in the second year of life and for human immunodeficiency virus HIV —exposed and stunted children. Since vaccine introduction, population rotavirus hospitalization incidence declined in infants by Comparing rotavirus cases with test-negative controls, VE was Despite higher VE against G1P than against other genotypes, no resurgence of nonvaccine genotypes has occurred.
VE did not differ significantly by nutritional status Despite differences in genotype-specific VE, no genotype has emerged to suggest vaccine escape. VE was not demonstrably affected by HIV exposure or stunting. Following randomized trial evidence of rotavirus vaccine efficacy in low-income settings [ 1 ] that led the World Health Organization WHO to recommend global implementation [ 2 ], as of August , 35 low-income African countries have introduced rotavirus vaccination into their Expanded Programme on Immunization schedules with support from Gavi, the Vaccine Alliance [ 3 ].
Monovalent rotavirus vaccine RV1 effectiveness VE and cost-effectiveness have been demonstrated following vaccine rollout in low-income, high-burden settings [ 4 — 6 ].
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