Impact of Rotavirus Vaccination on Diarrhea-related Hospitalizations Among Children <5 Years of Age in Mexico

Abstract

Single-strain rotavirus vaccine was added to the national immunization program in Mexico in May 2007. We assessed the impact of vaccination on the number of diarrhea-related hospitalizations in Mexican children in 2008 and 2009. We obtained data on all-cause diarrhea-related hospitalizations from January 2003 to June 2009 in Mexican children <5 years of age. We compared diarrhea-related hospitalizations during the 2008 and 2009 rotavirus seasons with the median number of diarrhea-related hospitalizations at baseline (2003-2006), before rotavirus vaccine introduction, at 306 Ministry of Health hospitals. We estimated vaccine coverage using administrative data. A median number of 10,993 diarrhea-related hospitalizations (range: 9877-11958) occurred each prevaccine rotavirus season from 2003 to 2006 among children < 5 years of age. Diarrhea-related hospitalizations decreased by 11% (N = 9836) in 2008 and by 40% (N = 6597) in 2009. The greatest declines occurred in infants < 12 months of age during 2008 (25%) and 2009 (52%), with 1-dose rotavirus vaccination coverage of 74% and 89% during these years, respectively. A 43% decline was also noted among children 12 to 23 months of age during the 2009 season. No declines were noted during either 2008 or 2009 among unvaccinated children >24 months of age during the study period. Marked declines in diarrhea-related hospitalizations among vaccine-eligible Mexican children < 24 months of age have occurred during the first 2 complete rotavirus seasons following rotavirus vaccination. Rotavirus-specific surveillance and epidemiologic studies are necessary for a better understanding of the changes in disease epidemiology and public health impact from rotavirus vaccination.