• Tessa Braeckman, Koen Van Herck, Nadia Meyer, Jean-Yves Pirçon, Montse Soriano-Gabarró, Elisabeth Heylen, Mark Zeller, Myriam Azou, Heidi Capiau, Jan De Koster, Anne-Sophie Maernoudt, Marc Raes, Lutgard Verdonck, Marc Verghote, Anne Vergison, Jelle Matthijnssens, Marc Van Ranst, Pierre Van Damme, and RotaBel Study Group.
• Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium.
• BMJ. 2012 Jan 1;345:e4752.

ObjectiveTo evaluate the effectiveness of rotavirus vaccination among young children in Belgium.DesignProspective case-control study.SettingRandom sample of 39 Belgian hospitals, February 2008 to June 2010.Participants215 children admitted to hospital with rotavirus gastroenteritis confirmed by polymerase chain reaction and 276 age and hospital matched controls. All children were of an eligible age to have received rotavirus vaccination (that is, born after 1 October 2006 and aged ≥ 14 weeks).Main Outcome MeasureVaccination status of children admitted to hospital with rotavirus gastroenteritis and matched controls.Results99 children (48%) admitted with rotavirus gastroenteritis and 244 (91%) controls had received at least one dose of any rotavirus vaccine (P<0.001). The monovalent rotavirus vaccine accounted for 92% (n=594) of all rotavirus vaccine doses. With hospital admission as the outcome, the unadjusted effectiveness of two doses of the monovalent rotavirus vaccine was 90% (95% confidence interval 81% to 95%) overall, 91% (75% to 97%) in children aged 3-11 months, and 90% (76% to 96%) in those aged ≥ 12 months. The G2P[4] genotype accounted for 52% of cases confirmed by polymerase chain reaction with eligible matched controls. Vaccine effectiveness was 85% (64% to 94%) against G2P[4] and 95% (78% to 99%) against G1P[8]. In 25% of cases confirmed by polymerase chain reaction with eligible matched controls, there was reported co-infection with adenovirus, astrovirus and/or norovirus. Vaccine effectiveness against co-infected cases was 86% (52% to 96%). Effectiveness of at least one dose of any rotavirus vaccine (intention to vaccinate analysis) was 91% (82% to 95%).ConclusionsRotavirus vaccination is effective for the prevention of admission to hospital for rotavirus gastroenteritis among young children in Belgium, despite the high prevalence of G2P[4] and viral co-infection.

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