3994 study participants we
re enrolled from six countries and we
re randomly assigned two oral doses of either RIX4414 (n=2646) or placebo (n=1348), which we
re coadministe
red with the first two doses of specific childhood vaccinations. Follow-up for gastroenteritis episodes was undertaken from 2 weeks post-dose two through the two consecutive rotavirus seasons following vaccinations (combined efficacy follow-up period; mean duration 17 months [SD 1·6]). Our primary endpoint was vaccine efficacy against rotavirus gastroenteritis of any severity during the first efficacy follow-up period (2 weeks post-dose two to the end of the first rotavirus season). Stool specimens obtained during gastroenteritis episodes we
re tested for rotavirus by ELISA and typed by RT-PCR. Episodes scoring 11 or g
reater on the 20-point Vesikari scale we
re classified as seve
re. Analysis was according to protocol. This study is
registe
red with ClinicalTrials.gov, number NCT00140686 (eTrack102247).
Findings
120 infants were excluded from the according-to-protocol analysis. During the first efficacy follow-up period (mean duration 5·7 months [SD 1·2]), 24 of 2572 infants allocated RIX4414 versus 94 of 1302 given placebo had rotavirus gastroenteritis episodes of any severity, resulting in a vaccine efficacy of 87·1%(95%CI 79·6–92·1; p<0·0001). For the combined efficacy follow-up period, vaccine efficacy against severe rotavirus gastroenteritis was 90·4%(85·1–94·1; p<0·0001), for admission owing to rotavirus gastroenteritis 96·0%(83·8–99·5; p<0·0001), and for rotavirus-related medical attention 83·8%(76·8–88·9; p<0.0001), and significant protection against severe rotavirus gastroenteritis by circulating G1, G2, G3, G4, and G9 rotavirus types was shown.
Interpretation
In a European setting, two doses of RIX4414 coadministered with childhood vaccines provided high protection against any and severe rotavirus gastroenteritis, with an overall reduction of admissions for gastroenteritis over two consecutive rotavirus epidemic seasons.