75 The Decline in Emergency Department Visits for Gastroenteritis After the Rotavirus Vaccine Was Greatest in Children in the Earliest Years of Life

Abstract

Background: Rotavirus gastroenteritis accounts for a significant number of emergency department (ED) visits in children. The CDC reported a decrease in rotavirus-positive cultures since the launch of a new oral vaccine in 2006, generally given in the first year of life. Study Objectives: We hypothesize that the decline in ED visits for gastroenteritis after the introduction of the rotavirus vaccine was greatest in children in the earliest years of life. Methods: Design: Retrospective cohort of ED visits. Setting: 28 suburban, urban and rural New York and New Jersey EDs with annual visits between 22,000 and 82,000. Population: Consecutive patients between 1-1-1996 and 12-31-2011. Protocol: For patients <10 years old, we identified gastroenteritis visits using ICD-9 codes. For each calendar year, we divided the gastroenteritis visits for each age group by the total ED visits for that age group (as a percent). For each age group we calculated the decreases from 2005 to 2011 in the percent visits and their 95% confidence intervals (CIs). Results: There were 7,740,823 total visits in the database and 1,183,088 (15%) had an age <10. The percent of gastroenteritis visits rose for all age groups from 1996 to 2005 and then decreased from 2005 to 2011. The decreases were greatest in the first 3 years of life: 1st, 41% (95% CI: 37%-45%); 2nd, 36% (95% CI: 32%-40%); 3rd, 27% (95% CI: 21%-33%). For the combined group of the 3rd through 10th years of life there was a decrease of 17% (95% CI 12%-21%). See figure. Conclusion: We found that the ED visits for gastroenteritis in patients <10 years old declined after the introduction of the rotavirus vaccine and that this effect was greatest in the earliest years of life.