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Uptake and timeliness of rotavirus vaccination in Norway: The first year post-introduction
Beatriz Valcarcel Salamanca1, Maria Elisabeth Hagerup-Jenssen1, Elmira Flem1
1Norwegian Institute of Public Health, Infection Control and Environmental Health, PO Box 4404, NO-0403 Oslo, Norway.
Insights
Norway achieved high rotavirus vaccine coverage (82% for two doses) within strict age limits, demonstrating a robust national immunization program. Introduction of rotavirus vaccine did not negatively impact uptake or timeliness of other infant vaccines.
Area of Science:
- Immunology
- Public Health
- Vaccinology
Background:
- Norway implemented strict age limits for rotavirus vaccination in October 2014 to minimize intussusception risk.
- Concerns existed that stringent age limits might reduce rotavirus vaccine coverage.
- The study aimed to assess rotavirus vaccine uptake and its impact on other infant immunizations.
Purpose of the Study:
- To document the coverage and adherence to schedules for rotavirus vaccination in Norway.
- To identify factors influencing the completion of the rotavirus vaccine series.
- To evaluate the impact of rotavirus vaccine introduction on the uptake and timeliness of other routine childhood vaccines.
Main Methods:
- Utilized individual vaccination data from the national immunization register.
- Calculated coverage rates for rotavirus and other vaccines.
- Employed logistic regression and Kaplan-Meier methods to analyze adherence, predictors, and changes in vaccine uptake.
Main Results:
- Achieved 89% coverage for one dose and 82% for two doses of rotavirus vaccine within the first year.
- 98% of fully vaccinated children received doses within age limits; 90% followed the recommended schedule.
- Child's age at initiation and co-administration of DTaP/IPV/Hib and pneumococcal vaccines were key predictors of completion. No significant changes in other vaccine uptake or timeliness were observed.
Conclusions:
- Norway successfully achieved high rotavirus vaccine coverage and adherence to strict age limits.
- The national immunization program proved robust, with rotavirus vaccination not affecting other infant vaccine schedules.
Background:
To minimise vaccine-associated risk of intussusception following rotavirus vaccination, Norway adopted very strict age limits for initiating and completing the vaccine series at the time rotavirus vaccination was included in the national immunisation programme, October 2014. Although Norway has a high coverage for routine childhood vaccines, these stringent age limits could negatively affect rotavirus coverage. We documented the status and impact of rotavirus vaccination on other infant vaccines during the first year after its introduction.
Methods:
We used individual vaccination data from the national immunisation register to calculate coverage for rotavirus and other vaccines and examine adherence with the recommended schedules. We identified factors associated with completing the full rotavirus series by performing multiple logistic regression analyses. We also evaluated potential changes in uptake and timeliness of other routine vaccines after the introduction of rotavirus vaccine using the Kaplan-Meier method.
Results:
The national coverage for rotavirus vaccine achieved a year after the introduction was 89% for one dose and 82% for two doses, respectively. Among fully rotavirus-vaccinated children, 98% received both doses within the upper age limit and 90% received both doses according to the recommended schedule. The child's age at the initiation of rotavirus series and being vaccinated with diphtheria, tetanus, pertussis, polio and Haemophilus influenzae type b (DTaP/IPV/Hib) and pneumococcal vaccines were the strongest predictors of completing the full rotavirus series. No major changes in uptake and timeliness of other paediatric vaccines were observed after introduction of rotavirus vaccine.
Conclusions:
Norway achieved a high national coverage and excellent adherence with the strict age limits for rotavirus vaccine administration during the first year of introduction, indicating robustness of the national immunisation programme. Rotavirus vaccination did not impact coverage or timeliness of other infant vaccines.
