Trial reportThe Journal of infectious diseases2018
Quantifying the Impact of Natural Immunity on Rotavirus Vaccine Efficacy Estimates: A Clinical Trial in Dhaka, Bangladesh (PROVIDE) and a Simulation Study.
Trial report in The Journal of infectious diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01375647 (Exploration of the Biologic Basis for Underperformance of Oral Polio and Rotavirus Vaccines in Bangladesh), which is not on this map. Cited by 35 papers, 6 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Exploration of the Biologic Basis for Underperformance of Oral Polio and Rotavirus Vaccines in Bangladesh
Who cites it
35 citing papers in PubMed, 6 syntheses or guidelines pooled it, 47 citations in OpenAlex.
- Is detection of enteropathogens and human or animal faecal markers in the environment associated with subsequent child enteric infections and growth: an individual participant data meta-analysis.The Lancet. Global health · 2024Pooled it
- Vaccines for preventing rotavirus diarrhoea: vaccines in use.The Cochrane database of systematic reviews · 2021Pooled it
- Real-world effectiveness of rotavirus vaccines, 2006-19: a literature review and meta-analysis.The Lancet. Global health · 2020Pooled it
- Vaccines for preventing rotavirus diarrhoea: vaccines in use.The Cochrane database of systematic reviews · 2019Pooled it
- Efficacy of live oral rotavirus vaccines by duration of follow-up: a meta-regression of randomised controlled trials.The Lancet. Infectious diseases · 2019Pooled it
- Vaccines for preventing rotavirus diarrhoea: vaccines in use.The Cochrane database of systematic reviews · 2019Pooled it
- Etiology and Incidence of Moderate-to-Severe Diarrhea in Young Children in Niger.Journal of the Pediatric Infectious Diseases Society · 2021Trial
- Trial
- Rotavirus vaccine efficacy up to 2 years of age and against diverse circulating rotavirus strains in Niger: Extended follow-up of a randomized controlled trial.PLoS medicine · 2021Trial
- Immune response to rotavirus vaccines in low- and middle-income countries: Challenges and perspectives.Human vaccines & immunotherapeutics · 2026Review
- Review
- Evaluation of rotavirus, pneumococcal conjugate and human papillomavirus vaccination in four Pacific island countries: A cost-effectiveness modelling study.PLoS medicine · 2026Article
- A narrative review of heterogeneity in SARS-CoV-2 infection outcomes and vaccine efficacy: strategizing pandemic preparedness in Africa.Frontiers in public health · 2026Review
- Natural history parameters for enteric pathogens to inform modeling studies of diarrhea among children in low-resource settings: results from the MAL-ED longitudinal birth cohort.BMC infectious diseases · 2025Article
- Efficacy of rotavirus vaccines in Indonesia: A review of genotype distribution and impact.Narra J · 2025Review
- Global estimates of rotavirus vaccine efficacy and effectiveness: a rapid review and meta-regression analysis.EClinicalMedicine · 2025Article
- Molecular ingredients of an immunogen for long-lasting IgG.Frontiers in immunology · 2025Review
- The impact of vaccines for diarrhoea on antibiotic use among children in five low-resource settings: a comparative simulation study.The Lancet. Global health · 2024Article
- Immunological factors linked to geographical variation in vaccine responses.Nature reviews. Immunology · 2024Review
- Prediction of effectiveness of universal rotavirus vaccination in Southwestern Vietnam based on a dynamic mathematical model.Scientific reports · 2024Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
Abstract
Background: The low efficacy of rotavirus vaccines in clinical trials performed in low-resource settings may be partially explained by acquired immunity from natural exposure, especially in settings with high disease incidence. Methods: In a clinical trial of monovalent rotavirus vaccine in Bangladesh, we compared the original per-protocol efficacy estimate to efficacy derived from a recurrent events survival model in which children were considered naturally exposed and potentially immune after their first rotavirus diarrhea (RVD) episode. We then simulated trial cohorts to estimate the expected impact of prior exposure on efficacy estimates for varying rotavirus incidence rates and vaccine efficacies. Results: Accounting for natural immunity increased the per-protocol vaccine efficacy estimate against severe RVD from 63.1% (95% confidence interval [CI], 33.0%-79.7%) to 70.2% (95% CI, 44.5%-84.0%) in the postvaccination period, and original year 2 efficacy was underestimated by 14%. The simulations demonstrated that this expected impact increases linearly with RVD incidence, will be greatest for vaccine efficacies near 50%, and can reach 20% in settings with high incidence and low efficacy. Conclusions: High rotavirus incidence leads to predictably lower vaccine efficacy estimates due to the acquisition of natural immunity in unvaccinated children, and this phenomenon should be considered when comparing efficacy estimates across settings. Clinical Trials Registration: NCT01375647.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.