Indirect impacts of infant rotavirus vaccination are apparent in the emergence of biennial patterns in rotavirus hospitalizations that extend to all age groups ineligible for vaccination, according to a recent study. These observations are consistent with the notion that young children are of primary importance in disease transmission and that the initial post-vaccination period of dramatic population-wide impacts will be followed by more complex incidence patterns across the age range in the long-term. Researchers examined data from the Healthcare Cost and Utilization Project State Inpatient Database in order to conduct a time-series analysis of monthly hospital discharges across age groups for acute gastroenteritis and rotavirus from 2000-2013. Rate ratios were calculated comparing pre- and post-vaccine eras. They found:
- Following vaccine introduction, a decrease in rotavirus hospitalizations occurred with a shift towards biennial patterns across all ages.
- The 0-4-year age group experienced the largest decrease in rotavirus hospitalizations.
- The 5-19- and 20-59-year age groups experienced significant declines in rotavirus hospitalization rates overall; even post-vaccine calendar years were characterized by progressively lower rates while odd post-vaccine years were associated with reductions in rates that diminished over time.
Baker JM, Tate JE, Steiner CA, Haber MJ, Parashar UD, Lopman BA. Longer-term direct and indirect effects of infant rotavirus vaccination across all ages in the US; 2000-2013: Analysis of a large hospital discharge dataset. [Published online ahead of print July 18, 2018]. Clin Infect Dis. doi:10.1093/cid/ciy580.
Although rotavirus vaccine is only administered to infants, review of data on rotavirus infections shows significant beneficial effects for all ages. This study looked at rotavirus hospitalizations for all age groups pre- and post-rotavirus vaccine introduction. Administering rotavirus vaccine to infants had beneficial effects for all age groups, even if those other age groups were not vaccinated. This is similar to the effect of giving influenza vaccine to infants, which significantly reduces the likelihood of influenza in those in close contact with them. Thus, vaccination of infants has important indirect effects in reducing the spread of infections in populations.—Sarah Rawstron, MB, BS, FAAP, FIDSA; Pediatric Residency Program Director, The Brooklyn Hospital Center, NY; Clinical Associate Professor, Icahn School of Medicine, Mount Sinai, NY.
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