Rotavirus vaccination in Germany: analysis of nationwide surveillance data 2006 to 2010.

BACKGROUND: Efficacy of rotavirus (RV) vaccination is difficult to assess outside of controlled clinical trials. In countries with low-to-moderate RV vaccination coverage, annual variation in RV outbreak might have a stronger influence on morbidity than RV vaccination. METHODS: We analyzed German RV surveillance data from 2006 to 2010 in the 16 federal states of Germany. To overcome the bias of annual variation of RV infections, we analyzed the effects of RV vaccination in Germany by comparing vaccination rate with morbidity as indicated by notification data. RESULTS: RV vaccination coverage in 0- to 1-year-old children in Germany increased from 3% in 2007 to 26% in 2010. The vaccination coverage varied highly between different federal states of Germany (2007, 1%-14%; 2008, 4%-35%, 2009, 8%-52%; and 2010, 17%-64%). There was a significant correlation between RV vaccination coverage and reduction in morbidity (r = -0.66, P = 0.0054) in 0- to <2-year-old children. The proportion of children vaccinated by one of the 2 vaccines, Rotarix and RotaTeq, was similar. Although we found a temporal delay of the epidemic RV seasons 2008 to 2010, those changes remained within the naturally occurring range. CONCLUSIONS: The overall RV vaccination coverage in Germany is still low as compared with other countries with vaccination-supporting policies. Initial data suggest an efficacy of the vaccination.