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Rotavirus Vaccines and Health Care Utilization for Diarrhea in US Children, 2001 to 2015
Halle B Getachew1, Rebecca M Dahl2, Benjamin A Lopman1,3
1From the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA.
Insights
Rotavirus vaccination significantly reduced diarrhea-related hospitalizations in US children. Both RotaTeq and Rotarix vaccines demonstrated high effectiveness and lasting protection against rotavirus in young children.
Area of Science:
- Pediatric infectious diseases
- Vaccinology
- Public health surveillance
Background:
- Rotavirus vaccination was introduced in the United States in 2006.
- Diarrhea-associated morbidity necessitates significant healthcare utilization in young children.
Purpose of the Study:
- To evaluate the impact of rotavirus vaccine implementation on diarrhea-related healthcare utilization.
- To determine the direct vaccine effectiveness (VE) of rotavirus vaccines in US children.
Main Methods:
- Retrospective cohort study utilizing claims data from US children under 5 years of age.
- Comparison of diarrhea-associated healthcare utilization rates between prevaccine and postvaccine introduction periods.
- Assessment of vaccine effectiveness and duration of protection for individual rotavirus vaccines.
Main Results:
- Substantial reductions in rotavirus-coded hospitalizations observed post-vaccine introduction, with rates decreasing by up to 98% in certain years.
- RotaTeq demonstrated high vaccine effectiveness (VE) against rotavirus hospitalization, ranging from 87% to 88% across age groups (3-59 months).
- Rotarix showed strong VE, ranging from 86% to 87% against rotavirus hospitalization in children aged 3-35 months.
Conclusions:
- Rotavirus vaccine implementation has led to a significant decrease in diarrhea-associated healthcare utilization among US children under 5.
- Both RotaTeq and Rotarix vaccines offer robust and sustained protection against rotavirus hospitalizations through the first four years of life.
Background:
Rotavirus vaccination was introduced in the United States in 2006. Our objectives were to examine reductions in diarrhea-associated health care utilization after rotavirus vaccine implementation and to assess direct vaccine effectiveness (VE) in US children.
Methods:
Retrospective cohort study using claims data of US children under 5 years of age. We compared rates of diarrhea-associated health care utilization in prevaccine versus postvaccine introduction years. We also examined VE and duration of protection.
Results:
Compared with the average rate of rotavirus-coded hospitalizations in the prevaccine years, overall vaccine rates were reduced by 75% in 2007 to 2008, 60% in 2008 to 2009, 94% in 2009 to 2010, 80% in 2010 to 2011, 97% in 2011 to 2012, 88% in 2012 to 2013, 98% in 2013 to 2014 and 92% in 2014 to 2015. RotaTeq-adjusted VE was 88% against rotavirus-coded hospitalization among 3-11 months of age, 88% in 12-23 months of age, 87% in 24-35 months of age, 87% in 36-47 months of age and 87% in 48-59 months of age. Rotarix-adjusted VE was 87% against rotavirus-coded hospitalization among 3-11 months of age, 86% in 12-23 months of age and 86% in 24-35 months of age.
Conclusion:
Implementation of rotavirus vaccines has substantially reduced diarrhea-associated health care utilization in US children under 5 years of age. Both vaccines provided good and enduring protection through the fourth year of life against rotavirus hospitalizations.
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