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Rotarix reduces rotavirus infection rates in vaccinated, unvaccinated populations
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Rates of rotavirus infection and acute gastroenteritis hospitalizations rapidly declined in both vaccinated and unvaccinated populations within the first year of implementing an infant Rotarix vaccination program in England and Wales, according to recent findings.
Rotarix (RV1, GlaxoSmithKline) was added to the countries’ immunization program in July 2013. The two-dose vaccine is administered orally to infants at ages 2 and 3 months.
“These results highlight infants as key mediators for sustaining rotavirus transmission within households and in the wider community,” Christina J. Atchison, MD, from the immunization, hepatitis and blood safety department at the Center for Infectious Disease Surveillance and Control in London, and colleagues wrote.
Atchison and colleagues used a surveillance program to compare monthly vaccination coverage in infants from October 2013 to March. Weekly reports of laboratory-confirmed rotavirus infections and hospital admissions for acute gastroenteritis provided by Public Health England and the Hospital Episodes Statistics database were assessed across all age groups. More than 206,000 rotavirus infections were reported during the observation period (July 2000 to June) and 2 million hospital admissions for all-cause acute gastroenteritis occurred from July 2007 to June 2014, including 0.7% considered rotavirus-specific.
Annual rates of rotavirus infections were stable during the pre-vaccination period and declined in all age groups in July 2013, mainly in infants aged younger than 1 year, according to the results. The decline appeared to correspond with the introduction of the vaccine and a 93% coverage rate in infants aged 25 weeks, the researchers wrote.
From 2013 to 2014, infants aged younger than 1 year displayed a 77% decrease in rotavirus infections (RR = 0.23; 95% CI, 0.16-0.32) and 26% decrease in hospitalizations for all-cause acute gastroenteritis (RR = 0.74; 95% CI, 0.65-0.84).
Patients aged 5 years or older and unvaccinated populations also demonstrated a 50% decrease in rotavirus infection (RR = 0.5; 95% CI, 0.37-0.67) and a reduction in acute gastroenteritis hospitalizations (P < .0001). The researchers estimated that in all age groups, 10,884 rotavirus infections and 50,427 all-cause acute gastroenteritis hospital admissions were prevented between 2013 and 2014. Ninety percent of the averted all-cause acute gastroenteritis hospitalizations were in unvaccinated populations, including 42% among patients aged at least 65 years.
“Our estimated averted [acute gastroenteritis] hospitalizations in unvaccinated age groups could represent large health care cost savings attributable to the vaccination program, and should be considered in future cost-effectiveness studies, which so far only considered cost benefits afforded by direct protection of children,” Atchison and colleagues wrote.
Low rates of laboratory-confirmed rotavirus infections also were observed from July 2014 to June, indicating sustained vaccine benefits during the program’s second year, the researchers said. – by Stephanie Viguers
Disclosure: The researchers report no relevant financial disclosures.
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