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Gastroenteritis Hospitalization Rates Drop After Use of Rotavirus Vaccine

Authors report 94% decrease in rotavirus-coded admissions among children

After implementation of rotavirus vaccination in 2006, all-cause acute gastroenteritis hospitalization rates among U.S. children younger than 5 years of age declined by 31% to 55% in each of the post-vaccine years from 2008 through 2012, according to a research letter published in the June 9 issue of JAMA.

Eyal Leshem, MD, of the Centers for Disease Control and Prevention, and colleagues examined both all-cause gastroenteritis and rotavirus-related hospitalizations among children younger than 5 years of age from 2000 through 2012. The researchers analyzed state inpatient databases of the Healthcare Cost and Utilization Project, which capture hospitalizations in community and academic hospitals. The analyses were restricted to 26 states that consistently reported hospital discharge data each year during 2000 through 2012. Approximately 74% of U.S. children younger than 5 years of age resided in these 26 states.

The analyses included 1,201,458 all-cause hospitalizations for acute gastroenteritis among children younger than 5 years of age during 2000 through 2012, of which 199,812 (17%) were assigned a rotavirus-specific code. The researchers found that, compared with the pre-vaccine average annual acute gastroenteritis hospitalization rate of 76 per 10,000 among children younger than 5 years of age, post-vaccine introduction rates declined by 31% in 2008, by 33% in 2009, by 48% in 2010, by 47% in 2011, and by 55% in 2012. Similar declines were noted in both males and females, in all race/ethnicity groups, and in all age groups, with the greatest reductions seen among children aged 6 months to 23 months.

Compared with the pre-vaccine average annual rotavirus-coded hospitalization rate of 16 per 10,000 among children younger than 5 years of age, the rates of rotavirus-coded hospitalizations after the introduction of the vaccine declined by 70% in 2008, by 63% in 2009, by 90% in 2010, by 79% in 2011, and by 94% in 2012.

By 2012, children 48 to 59 months of age (the oldest age group studied) were age-eligible for the vaccine, and during that year the estimated rotavirus vaccination coverage among children 19 to 35 months of age reached 69% compared with 44% to 67% during 2009 through 2011.

“With an increase in vaccine coverage, herd protection may have contributed to larger declines in rotavirus hospitalizations. In 2012, when vaccine coverage was highest, the greatest reductions were observed for all-cause acute gastroenteritis (55 percent) and rotavirus-coded (94 percent) hospitalizations,” the authors wrote.

“The most recent reported coverage of 73 percent for a full rotavirus vaccine series is lower than that of other established childhood vaccines, so our findings support continued efforts to increase rotavirus vaccine coverage.”

Sources: Medical Xpress; June 9, 2015; and JAMA; June 9, 2015.

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