Impact of rotavirus vaccination on rotavirus genotype distribution and diversity in England, September 2006 to August 2016

• Published in: Euro surveillance : bulletin européen sur les maladies transmissibles Vol. 24; no. 6; p. 38
• Main Authors: Hungerford, Daniel, Allen, David J, Nawaz, Sameena, Collins, Sarah, Ladhani, Shamez, Vivancos, Roberto, Iturriza-Gómara, Miren
• Format: Journal Article
• Language: English
• Published: Sweden Centre Europeen pour la Surveillance Epidemiologique du SIDA (European Centre for the Epidemiological Monitoring of AIDS) 07.02.2019; European Centre for Disease Prevention and Control (ECDC)
• Subjects: Antigens, Viral - genetics; Child; Child, Preschool; England - epidemiology; Epidemiological Monitoring; Epidemiology; Feces - virology; Female; Gastroenteritis - epidemiology; Gastroenteritis - prevention & control; Gastroenteritis - virology; Genetic Variation; Genotype; Genotype & phenotype; Humans; Immunization; Impact analysis; Infant; Infant, Newborn; Male; Multiplex Polymerase Chain Reaction; Prevalence; RNA, Viral - genetics; Rotavirus - classification; Rotavirus - genetics; Rotavirus - isolation & purification; Rotavirus Infections - epidemiology; Rotavirus Infections - prevention & control; Rotavirus Infections - virology; Rotavirus Vaccines - administration & dosage; Rotavirus Vaccines - immunology; Vaccination; Vaccines, Attenuated; Viruses; England; United Kingdom > UK; molecular methods; typing; epidemiology; surveillance; vaccine-preventable diseases; rotavirus
• ISSN: 1560-7917; 1025-496X; 1560-7917
• DOI: 10.2807/1560-7917.es.2019.24.6.1700774

IntroductionRotavirus vaccination with the live-attenuated 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.AimWe assessed the vaccine's impact on rotavirus genotype distribution and diversity 3 years post-vaccine introduction.MethodsEpidemiological 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).ResultsWe 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].ConclusionsIn 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.