Long-term Rotarix™ vaccine effectiveness in coastal Kenya, estimated from child hospital admissions data from July 2014 to December 2022

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ID: 332081
2026
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Abstract
Abstract Background Two doses of Rotarix™ demonstrated ∼64% effectiveness against rotavirus hospitalization in Kenyan children 2.5 years post-introduction. We evaluated long-term Rotarix™ effectiveness and monitored circulating genotypes over its 8.5 years of use in Kenya. Methods We conducted a test-negative case-control study in coastal Kenya among children admitted to Kilifi County Referral Hospital with diarrhea from July 2014 to December 2022. Eligible children had known Rotarix™ vaccination status, parent/guardian consent and rotavirus testing via ELISA. Positives were genotyped by sequencing. Rotarix™ effectiveness was estimated using unconditional logistic regression, adjusting for age, sex, calendar year, seasonality, and nutritional status. Results Of the 1,104 children (median age 12 months, interquartile range: 8–18) included in effectiveness analysis, 87% (962/1,104) had received 2 doses, 6% (70/1,104) 1 dose, and 7% (72/1,104) zero doses. Rotavirus was detected in stool specimens of 147 (13%) children. Overall, adjusted two dose Rotarix™ effectiveness was 68% (42–82%). Effectiveness in children ≤12 months was 83% (95% CI, 62–93%) compared to 38% (95% CI, -106–78%) in children >12 months. Genotyping of 147 positive samples revealed G3P[8] (66/147, 44.9%), G1P[8] (32/147, 21.8%), and G2P[4] (23/147, 15.6%) to be the most common circulating rotavirus genotypes during Rotarix™ vaccination era. Conclusions Rotarix™ maintained modest effectiveness in coastal Kenya during its 8.5 years of use. Effectiveness declined in the second year of life onwards probably reflecting a combination of both waning immunity and accumulation of natural immunity among unvaccinated children. Emergence of vaccine heterologous strains emphasizes need for continued effectiveness surveillance.
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Authors Kipkirui Zadock, Charity Wamwea, Esther Nyadzua Katama, Robinson Cheruiyot, Martin N. Mutunga, Agustus Kea, Charles N. Agoti, D. James Nokes, Umesh D. Parashar, Jacqueline E. Tate, Eunice Wangeci Kagucia, Charles N. Agoti
Journal Open forum infectious diseases
Year 2026
DOI
10.1093/ofid/ofag674
URL
https://doi.org/10.1093/ofid/ofag674
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