Impact of rotavirus vaccination on rotavirus genotype distribution and diversity in England, september 2006 to august 2016

Daniel Hungerford*, David J. Allen, Sameena Nawaz, Sarah Collins, Shamez Ladhani, Roberto Vivancos, Miren Iturriza-Go'Mara

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

46 Citations (Scopus)

Abstract

Introduction: Rotavirus vaccination with the liveattenuated monovalent (a G1P[8] human rotavirus strain) two-dose Rotarix vaccine was introduced in England in July 2013. Since then, there have been significant reductions in rotavirus gastroenteritis incidence. Aim: We assessed the vaccine’s impact on rotavirus genotype distribution and diversity 3 years post-vaccine introduction. Methods: Epidemiological and microbiological data on genotyped rotavirus-positive samples between September 2006 and August 2016 were supplied by EuroRotaNet and Public Health England. Multinomial multivariable logistic regression adjusting for year, season and age was used to quantify changes in genotype prevalence in the vaccine period. Genotype diversity was measured using the Shannon’s index (H’) and Simpson’s index of diversity (D). Results: We analysed genotypes from 8,044 faecal samples. In the pre-vaccine era, G1P[8] was most prevalent, ranging from 39% (411/1,057) to 74% (527/709) per year. In the vaccine era, G1P[8] prevalence declined each season (35%, 231/654; 12%, 154/1,257; 5%, 34/726) and genotype diversity increased significantly in 6-59 months old children (H’ p < 0.001: D p < 0.001). In multinomial analysis, G2P[4] (adjusted multinomial odds ratio (aMOR): 9.51; 95% confidence interval (CI): 7.02-12.90), G3P[8] (aMOR: 2.83; 95% CI: 2.17-3.81), G12P[8] (aMOR: 2.46; 95% CI: 1.62-3.73) and G4P[8] (aMOR: 1.42; 95% CI: 1.02-1.96) significantly increased relative to G1P[8]. Conclusions: In the context of reduced rotavirus disease incidence, genotype diversity has increased, with a relative change in the dominant genotype from G1P[8] to G2P[4] after vaccine introduction. These changes will need continued surveillance as the number and age of vaccinated birth cohorts increase in the future.

Original languageEnglish
Article number1700774
JournalEurosurveillance
Volume24
Issue number6
DOIs
Publication statusPublished - 7 Feb 2019

Bibliographical note

Funding Information:
Funding: Public Health England funded enhanced rotavirus surveillance from 2013. The authors received no financial support or other form of compensation related to the development of the manuscript. MIG receives support from The Wellcome Trust and the National Institute for Health Research Health Protection Research Unit in Gastrointestinal Infections at the University of Liverpool. DH was supported by the University of Liverpool.

Funding Information:
EuroRotaNet is funded by GlaxoSmithKline Biologicals (GSK) and Sanofi Pasteur, and Merck & Co., Inc. (Kenilworth, NJ USA) after the closure of Sanofi Pasteur-MSD in December 2016. Both funders were provided the opportunity to review a version of this manuscript for factual accuracy but the authors are solely responsible for final content and interpretation.

Publisher Copyright:
© 2019, European Centre for Disease Prevention and Control (ECDC). All rights reserved.

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