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Author Notes:

Corresponding author: Morehouse School of Medicine, Clinical Research Center, Department Microbiology/Biochemistry/Immunology and Pediatrics, 720 Westview Drive, SW Atlanta, GA 30310, USA. Tel.: +1 4047561394; fax: +1 4047566712. limmergluck@msm.edu (L. Immergluck)

We would like to thank Dr. Margaret Cortese for her comments and feedback.

We would like to thank Dr. Monica Farley and staff of Georgia’s Emerging Infections Program.

We would like to also thank Ms. Slavica Mijatovic-Rustemapasic, Dr. Jacqueline Tate, and Dr. Michael D. Bowen at the Centers for Disease Control and Prevention.

We would like to thank Dr. Amy Baxter, Dr. Philip Spandorfer, Ms. Shelley Mays, Ms. Elham Laghaie, and Mr. Kevin Thornton, Emergency Department staff at Scottish Rite Children’s Hospital, Egleston Children’s Hospital, and Hughes Spalding Children’s Hospital, and the Clinical Microbiology staff of Children’s Healthcare of Atlanta (especially, Mr. Charles Ash and Ms. Theresa Stanley).


Research Funding:

This work was funded through Centers for Disease Control and Prevention-Emerging Infections Program grants U01CI0000307-05 and U0I000312B; Georgia Emerging Infections Program Cooperative Agreement U50CK000196; PHS Grant UL1 RR025008 from the Clinical and Translational Science Award program, National Institute of Health, as part of the Atlanta Clinical & Translational Science Institute; Grant Number 2R25RR017694-06A1; and Grant Number G12-RR03034, a component of the National Institutes of Health.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Immunology
  • Medicine, Research & Experimental
  • Research & Experimental Medicine
  • Rotavirus
  • Rotavirus vaccination
  • Acute gastroenteritis
  • Pediatric

Association between mixed rotavirus vaccination types of infants and rotavirus acute gastroenteritis


Journal Title:



Volume 33, Number 42


, Pages 5670-5677

Type of Work:

Article | Post-print: After Peer Review


Introduction: Rotavirus remains the leading cause of severe diarrhea in children under 5 years worldwide. In the US, Rotarix® (RV1) and RotaTeq® (RV5), have been associated with reductions in and severity of rotavirus disease. Studies have evaluated the impact of RV1 or RV5 but little is known about the impact of incomplete or mixed vaccination upon vaccine effectiveness. Methods: Case control study to examine association of combined RV1 and RV5 and rotavirus acute gastroenteritis, factoring severity of diarrheal disease. Children born after March 1, 2009 with acute gastroenteritis from three pediatric hospitals in Atlanta, Georgia were approached for enrollment. Survey was administered, stool specimen was collected, and vaccination records were obtained. Results: 891 of 1127 children with acute gastroenteritis were enrolled. Stool specimens were collected from 708 for rotavirus testing; 215 stool samples tested positively for rotavirus. Children >12 months of age were more likely to have rotavirus. Children categorized with Vesikari score of >11 were almost twice as likely to be rotavirus positive. Prior rotavirus vaccination decreased the mean Vesikari score, p<. 0.0001. Children with complete single type vaccination were protected against rotavirus (OR 0.21, 95% CI: 0.14-0.31, p<. 0.0001). Conclusion: Complete rotavirus vaccination with a single vaccine type resulted in protection against rotavirus diarrhea and decrease in severity of rotavirus gastroenteritis. Incomplete rotavirus vaccination either with a single vaccine or mixed vaccination types also provided some protection.

Copyright information:

© 2015 Elsevier Ltd.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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