Rotavirus vaccine linked with decrease in acute gastroenteritis hospitalizations

1. Implementation of the rotavirus vaccine schedule was linked with decrease in all-cause gastroenteritis rates.

2. Gastroenteritis hospitalization rates declined similarly in males and females, all race/ethnicity groups, and all ages.

Evidence Rating Level: 2 (Good)

Study Rundown: Rotavirus is a contagious virus that is the most common cause of severe gastroenteritis in infants and young children worldwide. Symptoms include watery diarrhea, fever, and abdominal pain. In 2006, the rotavirus vaccine began to be administered on a routine basis in the United States. In order to determine the effectiveness of the vaccination program, the authors of this study examined rates of all-cause acute gastroenteritis and rotavirus-coded hospitalizations in children younger than five from 2002-2012.

It was found that all-cause acute gastroenteritis rates declined at increasing rates each year after 2008. Similar declines were seen in males and females, as well as all races and ages. It was also found that rotavirus-coded hospitalizations declined at even higher rates during each postvaccine year. This study was strengthened by restricting its analyses to only 26 states with consistent hospital data. However, it is weakened by a large number of unspecific gastroenteritis cases and probable underestimation of the true number of rotavirus cases. Based on these study results, efforts to promote rotavirus vaccination should continue to be made by physicians with the goal of attaining herd immunity. Further research is required to evaluate the exact impact of the rotavirus vaccine on rotavirus-coded hospitalizations in our country.

Click to read the study, published today in JAMA

Relevant Reading: Prevention of rotavirus gastroenteritis among infants and children: recommendations of the Advisory Committee on Immunization Practices

In-Depth [retrospective cohort]: This study evaluated 1,201,458 all-cause acute gastroenteritis cases in children younger than five during the years 2000-2012 in 26 states. 199,812 patients were diagnosed with a rotavirus specific gastroenteritis. Compared to the prevaccine mean annual acute gastroenteritis rate of 76 per 10,000 in children <5 years, postvaccine rates declined by 31% (95% CI, 30%-31%) in 2008 and further declined 55% (95% CI, 54%- 55%) in 2012. Compared with the prevaccine mean annual rotavirus-coded hospitalization rate of 16 per 10,000 among children <5 years, postvaccine rates declined by 70% (95% CI, 69%-71%) in 2008 and 94% (95% CI, 94%-95%) in 2012 (P < .001 for all rate reductions).

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