Rotavirus Vaccine Coverage and Potential Barriers Among US Children Born From 2007 to 2024

Area of Science:

• Pediatrics
• Vaccinology
• Public Health

Background:

• The Advisory Committee on Immunization Practices (ACIP) recommends rotavirus vaccine (RVV) first dose by 14 weeks, 6 days.
• RVV is not recommended until neonatal intensive care unit (NICU) discharge, potentially limiting timely vaccination.

Purpose of the Study:

• To investigate if current RVV guidelines hinder vaccination completion.
• To identify factors associated with missed RVV vaccination opportunities.

Main Methods:

• Analysis of vaccination status in children aged ≥15 weeks from the New Vaccine Surveillance Network (2014-2024).
• Inclusion criteria: rotavirus-negative acute gastroenteritis or healthy controls with known vaccination status.
• Univariate logistic regression used to identify risk factors for non-initiation or completion of RVV series.

Main Results:

• Over 24,755 children were included in the study.
• Strongest risk factors for not initiating RVV: delayed DTaP vaccine, extremely preterm birth, early RVV introduction period, and lack of health insurance.
• Over 50% of extremely preterm infants in NICUs were discharged after 15 weeks of age.

Conclusions:

• Current RVV guidelines may create barriers to timely vaccination.
• Allowing RVV administration in NICUs could improve vaccination coverage.
• Re-evaluation of RVV guidelines is recommended to enhance public health outcomes.