Fig. 1: Effectiveness of pneumococcal and rotavirus vaccines against illness and antibiotic treatment.

a–f, The estimated effectiveness against ARI and diarrhoea end points of PCV10/13 (a–c) and rotavirus vaccines (d–f) for all cases (a, d), cases for which treatment or advice was sought (b, e) and cases that were treated with antibiotics (c, f). Estimates were calculated as one minus the matched odds ratio and are shown as vaccine effectiveness. Analyses matched children with each end point to asymptomatic controls on the basis of country, age (within 1 month), visit timing (within 1 month), wealth quintile (country-specific), urbanicity and pentavalent vaccine doses received. The population available for analysis included 5,342 ARI cases (of whom 3,294 sought treatment or advice and 1,913 received antibiotics) and 57,856 controls without ARI; and 9,944 diarrhoea cases (of whom 7,382 sought treatment or advice and 1,437 received antibiotics) and 40,059 controls without diarrhoea (Supplementary Tables 1, 2). Points and lines indicate median estimates and 95% confidence intervals, respectively. We estimated vaccine effectiveness against negative-control end points (PCV10/13 effect against diarrhoea; rotavirus vaccine effect against ARI) to assess residual confounding as a validation step. PCV10/13 exposure was defined as ≥3 doses received. Because all countries in this analysis used Rotarix in their national immunization program, we defined ≥2 doses as a full rotavirus vaccination series. Numerical estimates can be found in Supplementary Tables 3–5. Quantiles are estimated through 2,000 independent draws from the distribution of estimates.