{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T22:43:37Z","timestamp":1792363417781,"version":"4.4.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Rotavirus vaccines are moderately protective against illness in settings with high compared with low mortality rates. Vaccine effectiveness (VE) evaluations may clarify our understanding of these disparities, but estimates among key subpopulations and against rare outcomes are not available in many analyses due to sample size. We combined 25 data sets from test-negative design case-control evaluations in 24 countries that enrolled children with medically attended diarrhea, laboratory-confirmed rotavirus stool testing, and documented vaccination status. We calculated rotavirus VE stratified by country-level characteristics.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Children 3\u201359 months old with birthdates and surveillance hospital arrival dates were included; other variables were standardized as available. Children were considered vaccinated if they received \u22651 dose of rotavirus vaccine &amp;gt;14 days before arrival. We summarized child- and country-level characteristics, including national &amp;lt;5-year-old mortality rate (U5M). Following the manufacturer recommended dose schedule, complete- and partial-series adjusted VE were estimated using logistic regression models.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We included 6626 rotavirus-positive children (case patients) and 19 459 rotavirus negative children (controls). Adjusted complete-series VE was significantly higher among children from countries in the low and medium U5M stratum (74% [95% confidence interval, 64%\u201381%]) compared with all groups within the high U5M stratum (range, 52% [42%\u201360%]) to 46% [31%\u201357%]). Partial-series estimates were lower than complete-series estimates.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>These findings are consistent with the published literature, though they suggest heterogeneity in vaccine performance within broad child mortality rate levels. Our findings also highlight the importance of complete-series vaccination.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/infdis\/jiae597","type":"journal-article","created":{"date-parts":[[2024,11,28]],"date-time":"2024-11-28T13:51:51Z","timestamp":1732801911000},"page":"308-315","source":"Crossref","is-referenced-by-count":14,"title":["Rotavirus Vaccine Effectiveness Stratified By National-Level Characteristics: An Introduction to the 24-Country MNSSTER-V Project, 2007\u20132023"],"prefix":"10.1093","volume":"232","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7541-6156","authenticated-orcid":false,"given":"Eleanor","family":"Burnett","sequence":"first","affiliation":[{"name":"Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jazmina","family":"Umana","sequence":"additional","affiliation":[{"name":"Expanded Program on Immunization , Ministerio de Salud, Managua, Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6989-0791","authenticated-orcid":false,"given":"Palwasha","family":"Anwari","sequence":"additional","affiliation":[{"name":"JS Consultancy , Kabul ,","place":["Afghanistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1615-3856","authenticated-orcid":false,"given":"Hilda A","family":"Mujuru","sequence":"additional","affiliation":[{"name":"Harare Central Hospital, University of Zimbabwe , Harare ,","place":["Zimbabwe"]},{"name":"Department of Paediatrics and Child Health, University of Zimbabwe , Harare ,","place":["Zimbabwe"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle J","family":"Groome","sequence":"additional","affiliation":[{"name":"Vaccines and Infectious Diseases Analytics Research Unit, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nguyen","family":"Van Trang","sequence":"additional","affiliation":[{"name":"National Institute of Hygiene and Epidemiology , Hanoi ,","place":["Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volga","family":"Iniguez","sequence":"additional","affiliation":[{"name":"Instituto de Biologia Molecular y Biotecnologia, Universidad Mayor de San Andres , La Paz ,","place":["Bolivia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stela","family":"Gheorghita","sequence":"additional","affiliation":[{"name":"National Center for Public Health, Ministry of Health of the Republic of Moldova , Chisinau ,","place":["Moldova"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1373-5319","authenticated-orcid":false,"given":"Gayane","family":"Sahakyan","sequence":"additional","affiliation":[{"name":"National Centre of Disease Control and Prevention, Ministry of Health of the Republic of Armenia , Yerevan ,","place":["Armenia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anvar","family":"Nazurdinov","sequence":"additional","affiliation":[{"name":"State Institution \u201cRepublican Center of Immunoprophylaxis\u201d, Ministry of Health and Social Protection of Population of the Republic of Tajikistan , Dushanbe ,","place":["Tajikistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2236-7420","authenticated-orcid":false,"given":"Fausta","family":"Michael","sequence":"additional","affiliation":[{"name":"Ministry of Health , Community Development, Gender, Elderly and Children, Dar es Salaam ,","place":["Tanzania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inacio","family":"Mandomando","sequence":"additional","affiliation":[{"name":"Centro de Investiga\u00e7\u00e3o em Sa\u00fade de Manhica , Maputo ,","place":["Mozambique"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Marie","family":"Desormeaux","sequence":"additional","affiliation":[{"name":"Haiti Country Office, US Centers for Disease Control and Prevention , Port-au-Prince ,","place":["Haiti"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umid","family":"Eraliev","sequence":"additional","affiliation":[{"name":"Tashkent Medical Academy , Tashkent ,","place":["Uzbekistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9346-5365","authenticated-orcid":false,"given":"Christabel","family":"Enweronu-Laryea","sequence":"additional","affiliation":[{"name":"Department of Child Health, University of Ghana Medical School , Accra ,","place":["Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cissy","family":"Nalunkuma","sequence":"additional","affiliation":[{"name":"Lubaga Hospital, Kampala ,","place":["Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isidore","family":"Bonkoungou","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Microbiology, University Joseph KI-ZERBO , Ouagadougou ,","place":["Burkina Faso"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1086-7559","authenticated-orcid":false,"given":"Khitam","family":"Muhsen","sequence":"additional","affiliation":[{"name":"School of Public Health, Faculty of Medical and Health Sciences, Tel Aviv University , Tel Aviv ,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Luhata Lungayo","sequence":"additional","affiliation":[{"name":"Programme \u00c9largi de Vaccination , Minist\u00e8re de la Sant\u00e9 Publique, Hygi\u00e8ne, et Prevention, Kinshasa ,","place":["Democratic Republic of Congo"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Omore","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute (KEMRI), Centre for Global Health Research , Kisumu ,","place":["Kenya"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0835-9504","authenticated-orcid":false,"given":"David M","family":"Goldfarb","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of British Columbia , Vancouver ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annick Lalaina","family":"Robinson","sequence":"additional","affiliation":[{"name":"CHU M\u00e8re Enfant Tsaralal\u00e0na , Antananarivo ,","place":["Madagascar"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"McCracken","sequence":"additional","affiliation":[{"name":"Center for Health Studies, Universidad del Valle de Guatemala , Guatemala City ,","place":["Guatemala"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeannine","family":"Uwimana","sequence":"additional","affiliation":[{"name":"Department of Pathology, Kigali University Teaching Hospital , Kigali ,","place":["Rwanda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kofi","family":"N\u2019Zue","sequence":"additional","affiliation":[{"name":"Country Office for Cote d\u2019Ivoire, World Health Organization , Abidjan ,","place":["C\u00f4te d\u2019Ivoire"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria","family":"Rey-Benito","sequence":"additional","affiliation":[{"name":"Department of Family, Health Promotion, and Life Course, World Health Organization Regional Office for 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,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8114-6196","authenticated-orcid":false,"given":"Jacqueline E","family":"Tate","sequence":"additional","affiliation":[{"name":"Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,11,28]]},"reference":[{"key":"2025092901215519500_jiae597-B1","doi-asserted-by":"crossref","first-page":"97","DOI":"10.2217\/fmb-2017-0128","article-title":"Causes of impaired oral vaccine efficacy in developing countries","volume":"13","author":"Parker","year":"2018","journal-title":"Future Microbiol"},{"issue":"12 suppl 2","key":"2025092901215519500_jiae597-B2","doi-asserted-by":"crossref","first-page":"S792","DOI":"10.1093\/infdis\/jiab399","article-title":"Global experience 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