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Published on: January 28, 2019
Reduction in gastroenteritis with the use of pentavalent rotavirus vaccine in a primary practice
Rodolfo E Bégué1, Keith Perrin
1Department of Pediatrics, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA. rbegue@lsuhsc.edu
Insights
The pentavalent rotavirus vaccine (RV5) significantly reduced acute gastroenteritis (AGE) office visits and hospitalizations in children. This reduction, particularly in rotavirus-positive cases, suggests a herd-immunity effect in the pediatric population.
Area of Science:
- Pediatric infectious diseases
- Vaccinology
- Public health
Background:
- Rotavirus (RV) is a leading cause of acute gastroenteritis (AGE) in young children.
- The pentavalent rotavirus vaccine (RV5) was introduced in 2006 for routine childhood immunization.
- Previous studies indicated a decrease in RV hospitalizations post-vaccine introduction.
Purpose of the Study:
- To evaluate the impact of the pentavalent rotavirus vaccine (RV5) on acute gastroenteritis (AGE) in a primary care pediatric practice.
- To assess changes in AGE-related office visits, emergency department visits, and hospital admissions following RV5 implementation.
Main Methods:
- Surveillance of children younger than 5 years presenting with AGE in a large pediatric practice from July 2004.
- Data collection included primary care office visits, emergency department visits, and hospital admissions.
- Rotavirus (RV) testing was conducted for hospitalized patients.
Main Results:
- Vaccine uptake reached 45.6% by 2008-2009.
- Significant decreases observed in all-cause AGE office visits (23%) and hospitalizations (50%) during 2007-2009 compared to pre-vaccine years (2004-2005).
- Rotavirus-positive cases (ED visits or hospitalizations) decreased by 67%, with a more pronounced effect in children under 2 years (81% reduction).
Conclusions:
- Increased use of the pentavalent rotavirus vaccine (RV5) in a pediatric practice correlated with reduced AGE burden.
- The observed reduction in rotavirus-positive AGE extended to unvaccinated older children, indicating a potential herd-immunity effect.
- RV5 vaccination is effective in decreasing AGE-related healthcare utilization in young children.
Objectives:
Pentavalent rotavirus (RV) vaccine (RV5) was licensed in 2006 and recommended for routine childhood immunization. A significant decrease in the number of RV hospitalizations has been described. The objective of this study was to evaluate the effect of RV5 on acute gastroenteritis (AGE) seen in a primary practice.
Methods:
In July 2004, surveillance was initiated among children who were younger than 5 years and seen in a large pediatric practice in New Orleans for those who presented AGE, as determined by International Classification of Diseases, Ninth Revision codes. Primary care physician office visits, emergency department visits, and hospital admissions were identified by review of records. RV testing was performed only on those who were seen at the hospital.
Results:
Approximately 16,000 children who were younger than 5 years were followed in the practice during each year. For 2006-2007, 2007-2008, and 2008-2009, 11.1%, 40.3%, and 45.6% of age-eligible children, respectively, received > or =1 dose of RV5. As compared with 2004-2005 (before RV5), in 2007-2009, there was a significant decrease in all-cause AGE office visits (23%) and hospitalizations (50%). RV-positive cases (emergency department visits or hospitalizations) decreased by 67%. The decrease in RV-positive cases was more evident among children who were younger than 2 years (81%), with a strong trend among those who were aged 2 to <5 years (41%).
Conclusions:
Increased use of RV5 in a pediatric practice was associated with fewer AGE office visits and hospitalizations. The reduction was specific for RV-positive AGE and seen among children who were targeted for immunization as well as older groups, suggesting a herd-immunity effect.
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