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

Hungerford, Daniel J ORCID: 0000-0002-9770-0163, Allen, David J, Nawaz, Sameena, Collins, Sarah, Ladhani, Shamez, Vivancos, Roberto and Iturriza-Gomara, Miren ORCID: 0000-0001-5816-6423
(2019) Impact of rotavirus vaccination on rotavirus genotype distribution and diversity in England, September 2006 to August 2016. Eurosurveillance, 24 (6). pp. 38-48.

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Introduction Rotavirus 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. 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.

Item Type: Article
Uncontrolled Keywords: Feces, Humans, Rotavirus, Rotavirus Infections, Gastroenteritis, RNA, Viral, Vaccines, Attenuated, Rotavirus Vaccines, Antigens, Viral, Vaccination, Prevalence, Genotype, Child, Child, Preschool, Infant, Infant, Newborn, England, Female, Male, Genetic Variation, Multiplex Polymerase Chain Reaction, Epidemiological Monitoring
Depositing User: Symplectic Admin
Date Deposited: 08 Feb 2019 08:58
Last Modified: 19 Jan 2023 01:04
DOI: 10.2807/1560-7917.ES.2019.24.6.1700774
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