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Rotavirus Vaccination in Germany: Analysis of Nationwide Surveillance Data 2006 to 2010

Uhlig, Ulrike MD*; Kostev, Karel DMSc; Schuster, Volker MD, PhD; Uhlig, Holm H. MD, DPhil

The Pediatric Infectious Disease Journal: December 2011 - Volume 30 - Issue 12 - p e244–e247
doi: 10.1097/INF.0b013e31822d1408
Online-Only: Original Studies

Background: Efficacy of rotavirus (RV) vaccination is difficult to assess outside of controlled clinical trials. In countries with low-to-moderate RV vaccination coverage, annual variation in RV outbreak might have a stronger influence on morbidity than RV vaccination.

Methods: We analyzed German RV surveillance data from 2006 to 2010 in the 16 federal states of Germany. To overcome the bias of annual variation of RV infections, we analyzed the effects of RV vaccination in Germany by comparing vaccination rate with morbidity as indicated by notification data.

Results: RV vaccination coverage in 0- to 1-year-old children in Germany increased from 3% in 2007 to 26% in 2010. The vaccination coverage varied highly between different federal states of Germany (2007, 1%–14%; 2008, 4%–35%, 2009, 8%–52%; and 2010, 17%–64%). There was a significant correlation between RV vaccination coverage and reduction in morbidity (r = −0.66, P = 0.0054) in 0- to <2-year-old children. The proportion of children vaccinated by one of the 2 vaccines, Rotarix and RotaTeq, was similar. Although we found a temporal delay of the epidemic RV seasons 2008 to 2010, those changes remained within the naturally occurring range.

Conclusions: The overall RV vaccination coverage in Germany is still low as compared with other countries with vaccination-supporting policies. Initial data suggest an efficacy of the vaccination.

From the *University Hospital for Children and Adolescents, Martin Luther University Halle—Wittenberg, Halle (Saale), Germany; †Institute of Medical Statistics (IMS) Health GmbH & Co, OHG, Frankfurt/Main, Germany; and ‡University Hospital for Children and Adolescents, Section of Pediatric Gastroenterology, University of Leipzig, Leipzig, Germany, and Translational Gastroenterology Unit, University of Oxford, United Kingdom.

Accepted for publication July 10, 2011.

Supported partially by the Wilhelm-Roux research grant of the Martin-Luther-University Halle (to U.U.).

U.U. and H.H.U. developed the concept and wrote the first draft of the manuscript. K.K., U.U., and H.H.U. performed the database search. All authors discussed data and approved the manuscript.

The access to all databases was provided without a payment. No other funding, payment, or honorarium was provided.

H.H.U. received travel support of the GlaxoSmithKline (GSK) foundation in 2005. V.S. received investigator fees from GSK and is a member of the rotavirus advisory board of Sanofi Pasteur MSD. K.K. is employed by IMS Health GmbH & Co. OHG, Frankfurt am Main, Germany. IMS health has business contracts with GSK and Sanofi Pasteur MSD.

The authors have no other funding or conflicts of interest to disclose.

Address for correspondence: Holm H. Uhlig, MD, DPhil, Translational Gastroenterology Unit, Experimental Medicine, University of Oxford, John Radcliffe Hospital, Oxford, OX3 9DU, United Kingdom. E-mail:

© 2011 Lippincott Williams & Wilkins, Inc.