There was a predominance of the G2P [4] genotype (51.3%, n = 80) followed by G1P [8] (15.4%, n = 24). Of all learn more observed genotypes, G2 was found in 57% (n = 89) and G1 in 23% (n = 36). The other genotypes characterized were: mixed groups (n = 14), G9 (n = 6), G3 (n = 3), and unusual strains such as G12 (n = 2) and Group C (n = 1). Mixed infections and

unusual genotypes were identified in 10.9% of the RV-A positive samples. The two-dose adjusted VE (adjusted for year of birth and the frequency matching variables) was 76% (95%CI: 58–86) (Table 1). Effectiveness controlled by the available potential confounders was very similar (72%, 95%CI: 44–85), suggesting no appreciable confounding by those factors for which adjustment was made. We excluded a similar proportion of cases (5.7%) and controls (5.3%) because they did not have cards. Sensitivity analysis showed that

if they were included as vaccinated, VE (two doses) would be 66% (95%CI: 42–80) and if included as unvaccinated VE would be 74% (95%CI: 53–86). The VE (adjusted for year of birth and the frequency matching variables) for one dose was 62% (95%CI: 39–97) and one dose VE adjusted for other potential confounders was 60% (95%CI: 37–75). Table 2 shows that VE was similar in those with time since second dose vaccination until hospitalization stratified by one year (71%; 95%CI: 54–82) and Tyrosine Kinase Inhibitor Library in vitro two years (78%; 95%CI: 52–90). The VE for G1P[8] and G2P[4] by time since second dose vaccination was marginally higher for G1P[8](90%; 95%CI:-0.92–-100 for one year and 89%; 95%CI: 0.01–-99 for two years) than see more G2P[4] (77%; 95%CI: 57–88 for one year and 75%; 95%CI: 56–86 for two years) significant. Table 3 presents genotype-specific VE by number of doses. VE (two doses) was 89% (95%CI: 78–95) for G1P[8]; 76% (95%CI: 64–84) for G2P [4]; 74% (95%CI: 35–90) for all G1; 76% (95%CI: 63–84) for all G2 and

63% (95%IC: −27–99) for all the non G1/G2 genotypes. Estimated VE remained very similar when analysis was stratified by year of admission suggesting that VE did not change with increasing vaccine coverage (data not presented). Two-dose VE was 76% (95%CI: 44–85), in spite of the great diversity of rotavirus genotypes circulating in Brazil and a predominance of G2P[4] genotype (51.3%). We found a 10.9% mixed and unusual genotypes as expected in developing countries [31] and [32]. The VE lasted for two years after second dose vaccination and it was higher for G1P[8] than G2P[4]. Variation of RV-A vaccine efficacy and effectiveness have been reported in the literature: efficacy was higher in Europe (96.4% against RV-A severe AD) [11] than in a low income country (Malawi, 49.2% against all diarrhea and 57.5% against hospitalized diarrhea) [13] and in countries with high mortality (63%) [33]. In the middle income countries of Latin America [12], efficacy was 84.8% against severe AD; in South Africa it was 72.2% against all diarrhea [13].