Infant rotavirus vaccine protected older children, adults

Andi L. Shane, MD, MPH, MSc

Researchers from the Centers for Disease Control and Prevention nicely demonstrate the indirect benefits of infant rotavirus immunization through reduction of the burden of disease. Although rotavirus-coded discharge diagnoses were decreased most notably in children 0 to 4 years of age, reductions were also noted among 5 to 14 year olds and 15 to 24 year olds, compared to similar data in the pre-rotavirus vaccine era. These reductions likely underestimate the true reduction in rotavirus-associated discharge coding as many providers do not consider rotavirus testing in adolescents and adults. Similar reductions in gastroenteritis-related discharges were noted, suggesting that rotavirus infections contribute substantially to gastroenteritis.

The clinical ramifications of the reduction in rotavirus-attributed as well as all-cause gastroenteritis are significant, especially to providers who trained and practiced in the pre-rotavirus vaccine era. Oral and intravenous rehydration calculations were a daily activity in the late winter and early spring months for many. Fortunately for our trainees, patients, and their parents in the post-rotavirus vaccine era, these calculations are a rare event. After an initial introduction complicated by an association with intussusception, withdrawal, and a 7 year wait for a new formulation of a rotavirus vaccine, we can now celebrate the success of infant rotavirus vaccination. With two oral rotavirus vaccine formulations available in the United States to eligible infants, we are poised to celebrate the 40^th anniversary of the identification of rotavirus by Ruth Bishop and colleagues from children with gastroenteritis at Royal Children's Hospital, Melbourne in 1973.