JAMA: Following 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 percent – 55 percent in each of the post-vaccine years from 2008 through 2012, according to a study in the June 9 issue of JAMA.
Eyal Leshem, M.D., of the U.S. Centers for Disease Control and
Prevention, Atlanta, and colleagues examined both all-cause
gastroenteritis and rotavirus-related hospitalizations among children
younger than 5 years 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 percent of U.S. children younger than 5 years resided
in these 26 states.
The analyses included 1,201,458 all-cause acute gastroenteritis
hospitalizations among children younger than 5 years of age during 2000
through 2012, of which 199,812 (17 percent) 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, post-vaccine
introduction rates declined by 31 percent in 2008, 33 percent in 2009,
48 percent in 2010, 47 percent in 2011, and 55 percent in 2012. Similar
rate declines were noted in both males and females, all race/ethnicity
groups, and all age groups, with the greatest reductions among children
age 6 months to 23 months.
Compared with the pre-vaccine average annual rotaviruscoded
hospitalization rate of 16 per 10,000 among children younger than 5
years, rates of rotaviruscoded hospitalizations post-vaccine
introduction declined by 70 percent in 2008, 63 percent in 2009, 90
percent in 2010, 79 percent in 2011, and 94 percent in 2012.
By 2012, children 48-59 months of age (the oldest age group studied)
were age eligible for the vaccine and during this year the estimated
rotavirus vaccination coverage among children 19-35 months of age
reached 69 percent compared with 44 percent – 67 percent 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 write.
“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