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Equity and impact: Ontario's infant rotavirus immunization program five years following implementation. A
Sarah E Wilson1, Laura C Rosella1, Jun Wang2
1Public Health Ontario, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
Vaccine
|February 16, 2019
Summary
Ontario's rotavirus (RV) immunization program significantly reduced hospitalizations and emergency department visits for acute gastroenteritis (AGE) in children. The program also lessened health inequities related to RV-AGE burden.
Area of Science:
- Public Health
- Infectious Diseases
- Vaccinology
Background:
- Ontario introduced a publicly-funded rotavirus (RV) immunization program in 2011.
- The study aimed to assess the program's impact on hospitalizations and emergency department (ED) visits for acute gastroenteritis (AGE) five years post-implementation.
Purpose of the Study:
- To evaluate the effectiveness of the rotavirus immunization program in reducing hospitalizations and ED visits for AGE.
- To assess the impact on different age groups and explore potential equity implications.
Main Methods:
- A population-based longitudinal retrospective cohort study design was employed.
- ICD-10 codes were used to identify hospitalizations and ED visits for RV-AGE and overall AGE from August 2005 to March 2016.
- Negative binomial regression models adjusted for age, seasonality, and secular trends were used to calculate rates and rate ratios (RRs).
Main Results:
- Rotavirus AGE hospitalizations and ED visits in children under five decreased by 76% and 68%, respectively.
- Overall AGE hospitalizations and ED visits in children under five declined by 38% and 26%, respectively.
- Health disparities in RV-AGE hospitalizations between marginalized and least marginalized neighborhoods were reduced post-program implementation.
Conclusions:
- The routine infant rotavirus immunization program in Ontario has demonstrated a substantial population health impact.
- The findings confirm herd effects and suggest a reduction in health inequities associated with pediatric rotavirus hospitalizations.