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Published on: January 28, 2019

Role of Vaccine Age Restrictions on Rotavirus Vaccine Coverage, Vaccine Safety Datalink 2018-2024

Jordan Cates1, Jacob Haapala2, Julia Baker1

  • 1Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States.

Journal of the Pediatric Infectious Diseases Society
|July 14, 2026
PubMed

Insights

Delays in routine childhood vaccinations, particularly during the COVID-19 pandemic, impacted rotavirus vaccine (RV) initiation and completion. Age restrictions on RV doses may hinder timely administration, especially for at-risk populations.

Area of Science:

  • Pediatric Vaccinology
  • Public Health Policy
  • Epidemiology

Background:

  • Rotavirus vaccines (RVs) are routinely coadministered with diphtheria-tetanus-acellular pertussis (DTaP) vaccines in the U.S.
  • Both vaccine types have specific age restrictions for administration.
  • Delays in preventive care visits can affect vaccination timeliness.

Purpose of the Study:

  • To examine the impact of delayed preventive care visits on rotavirus vaccine (RV) initiation and series completion.
  • To identify risk factors associated with delayed DTaP vaccination and missed RV vaccination.
  • To assess the influence of age restrictions on RV vaccination timeliness.

Main Methods:

  • Comparative analysis of vaccination timeliness in children born between January 1, 2018, and June 30, 2023.
  • Utilized data from eight U.S. health systems.
  • Employed modified Poisson regression to estimate adjusted risk ratios (aRR) for delayed vaccinations.

Main Results:

  • 3.2% of children initiating DTaP did not initiate RV.
  • Delayed DTaP initiation led to age-ineligibility for RV in 61.5% of non-initiators.
  • Higher risk of delayed DTaP and no RV initiation observed during early COVID-19 pandemic, with fewer primary care visits, and among Medicaid recipients.

Conclusions:

  • Age restrictions for rotavirus vaccines may contribute to missed initiation and incomplete series.
  • Targeted public health strategies are necessary for at-risk populations to ensure timely RV administration.
  • Addressing delays in preventive care is crucial for maintaining vaccination schedules.
Abstract

Keywords:
coveragediarrhearotavirusvaccination

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