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Low rotavirus vaccine coverage linked to greater rates of rotavirus
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Locations with the lowest rotavirus vaccine coverage had the highest detected rates of rotavirus, according to study findings in Pediatrics.
“Uptake of rotavirus vaccines has steadily increased each year since introduction, with national full-series coverage (either two or three doses depending on vaccine type) reaching 67% in 2011,” study researcher Leila C. Sahni, MPH, of Texas Children’s Hospital, and colleagues wrote. “Despite the demonstrated impact of rotavirus vaccines, full-series coverage 5 years after introduction of rotavirus vaccines remains lower than for other vaccines recommended at 2, 4, and 6 months of age, for which coverage is 93% to 95%.”
Researchers reviewed medical records for children enrolled in an acute gastroenteritis surveillance program to determine rotavirus vaccination coverage, location of vaccination, and rotavirus disease rates. Rotavirus detection rates among children with severe acute gastroenteritis were calculated by vaccine coverage category. Children were aged younger than 5 years.
During the 2009 to 2010 and 2010 to 2011 rotavirus seasons, 2,197 children with acute gastroenteritis and 1,523 children with acute respiratory infection were enrolled in the study. One hundred children tested positive for rotavirus. Six hundred seventy of the patients with acute respiratory infection tested negative for rotavirus and served as controls, along with 725 rotavirus-negative children with acute gastroenteritis.
Among controls, 80.4% received at least one dose of rotavirus vaccine at 68 locations. Four locations, including a neonatal ICU (5.9%), were considered to have low coverage; 22 (32.3%) were considered medium coverage; and 42 (61.8%) were considered to have high coverage.
Researchers considered a location where less than 40% of children received at least one dose of rotavirus vaccine to have low coverage; locations where 40% to 79% received at least one dose had medium coverage, and locations where 80% or more received at least one dose had high coverage.
In low-coverage locations, 12.5% of children eligible for rotavirus vaccine were fully vaccinated, compared with 49.3% in medium-coverage locations and 67.9% in high-coverage locations.
Of children eligible for full vaccination, 87.5% received no doses of rotavirus vaccine in low-coverage locations, compared with 29.5% in medium-coverage locations and 10.3% in high-coverage locations.
Rotavirus was detected in 31.4% of children with acute gastroenteritis from low-coverage locations vs. 9.6% from high-coverage locations (incidence rate ratio=3.3; 95% CI, 2.4-4.4).
“These findings suggest that the failure of providers to consistently offer rotavirus vaccine to age-eligible children may result in susceptible children who serve as reservoirs of ongoing disease transmission,” Sahni and colleagues wrote. “Initiating rotavirus vaccination at the time of NICU discharge has logistical challenges and infants many no longer be age-eligible, thereby leaving these vulnerable infants unvaccinated.”
Disclosure: The researchers report no relevant financial disclosures.
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