Effectiveness of Lanzhou Lamb Rotavirus Vaccine and RotaTeq Against Hospitalized Rotavirus Infections Among Children During 2020-2023 in Guangdong Province, China: A Test-Negative Case-Control Study.

Introduction: The evidence regarding the effectiveness of Lanzhou Lamb Rotavirus Vaccine (LLR) and RotaTeq (RV5) against gastroenteritis (RVGE) caused by emerging genotypes in Chinese children remains limited. Methods: We conducted a test-negative case–control study using gastroenteritis surveillance data from four cities (2020–2023) in Guangdong Province, China. Children aged 2 months to 5 years hospitalized with acute gastroenteritis were enrolled. Cases were rotavirus-positive; controls were rotavirus-negative. Vaccine effectiveness (VE) was estimated using multivariable logistic regressions. Results: Among 2650 children, 218 (8.2%) were rotavirus-positive, predominantly G8P[8]. Also, 1543 (58.23%) children were unvaccinated, while 632 (23.85%) and 475 (17.92%) received at least one dose of RV5 and LLR, respectively. Adjusted RV5 VE against any RVGE severity was 51.7% [95% confidence interval (CI) − 58.1–85.3%]) for one dose, 37.6% (95% CI − 58.5–75.4%) for two doses, and 64.1% (95% CI 38.0–79.2%) for three doses. For LLR, VE against any RVGE severity was 38.7% (95% CI 5.7–60.2%) for one dose, 74.6% (95% CI 35.3–90.0%) for two doses, and 58.8% (95% CI − 217.6–94.6%) for three doses. Against severe RVGE, RV5 VE was 67.2% (95% CI − 144.7–95.6%) for one dose, 74.0% (95% CI − 92.1–96.5%) for two doses, and 86.6% (95% CI 56.8–95.9%) for three doses. For LLR, VE against severe RVGE was 57.7% (95% CI 20.3–77.6%) for one dose, 73.4% (95% CI 11.9–92.0%) for two doses, and − 27.8% (95% CI − 949.7–84.4%) for three doses. Conclusions: Both RV5 and LLR provided protection against RVGE, including the emerging G8P[8] genotype. Three doses of RV5 offered strong protection, while two doses of LLR also appeared to be an effective strategy against rotavirus infection. Plain Language Summary: Rotavirus is a common cause of severe diarrhea in young children, and vaccines are crucial in preventing this illness. This study looked at how well two rotavirus vaccines, Lanzhou Lamb Rotavirus Vaccine (LLR) and RotaTeq (RV5), protect children against rotavirus gastroenteritis (RVGE), including infections caused by a new strain called G8P[8]. We analyzed data from children aged 2 months to 5 years who were hospitalized between 2020 and 2023. We compared children who tested positive for rotavirus (cases) with those who tested negative (controls) to determine how well the vaccines worked. Our results showed that both RV5 and LLR vaccines provided protection against RVGE. For RV5, three doses provided strong protection, while for LLR, two doses provided good protection. Against severe RVGE, three doses of RV5 were effective, while two doses of LLR also showed good protection. [ABSTRACT FROM AUTHOR]