Implementation of a rotavirus vaccination program in Ontario resulted in significant decreases in hospitalizations and ED utilization, according to results published in PLoS One.
In 2011, Ontario launched a provincewide rotavirus immunization program for infants at ages 2 and 4 months. In their analysis, the researchers reviewed more than 860,000 hospitalization and ED records over 8 years, both before vaccinations started and then from the start of the program in August 2011 through March 31, 2013.
“We were very excited to see the significant impact of the rotavirus vaccine program,” researcher Sarah E. Wilson, MD, MSc, of Public Health Ontario and the Institute for Clinical Evaluative Sciences, said in a press release. “Hospitalizations in Ontario due to rotavirus infection were reduced by 71%, and emergency department visits dropped by 68%.”
Figure 1. Ontario rotavirus hospitalizations dropped more than 70% after the launch of an infant vaccine program, according to researchers.
Source: Bryon Skinner, CDC/Erskine Palmer, PhD
Before initiating the immunization program with the Rotarix (RV1, GlaxoSmithKline) vaccine, rotavirus infection was responsible for 10% to 40% of cases of childhood acute gastroenteritis in Ontario, with one-third of infected children seeing a physician, 15% visiting an ED and 7% requiring hospitalization.
The start of the rotavirus vaccination program was associated with reductions in hospitalizations for acute gastroenteritis for all age cohorts younger than 20 years. The most dramatic impact occurred among infants aged younger than 12 months, for whom the rate dropped by 79% (RR = 0.21; 95% CI, 0.11-0.4). For children aged 12 to 23 months, the hospitalization rate dropped 73% (RR = 0.27; 95% CI, 0.16-0.48).
Overall hospitalizations for rotavirus-associated gastroenteritis declined by 71%, a significantly greater reduction than overall acute gastroenteritis hospitalizations over that same period (32%).
Vaccination also was associated with a 68% reduction in rotavirus-related ED visits (RR = 0.32; 95% CI, 0.2-0.52), including a 77% reduction among children aged 12 to 23 months (RR = 0.23; 95% CI, 0.08-0.63).
The researchers noted significant reductions in hospitalizations and ED visits even in children who were ineligible for vaccination, suggesting a substantial herd immunity benefit to the program.
“We expected to see a drop for babies and toddlers who were vaccinated under this program,” Wilson said in the release. “What’s particularly interesting is we saw the drop even in older kids who were too old to receive the publicly funded rotavirus vaccine, which means that protecting babies against illness also benefited older children.” – by Chris Rosenberg
Disclosure: The researchers report no relevant financial disclosures.