Abstract
BackgroundRotavirus vaccination was introduced into the Australian National Immunisation Program in mid-2007. We aimed to assess the impact of the rotavirus vaccination program on the burden of hospitalizations associated with all-cause acute gastroenteritis (including rotavirus gastroenteritis and non-rotavirus gastroenteritis) in the Aboriginal and non-Aboriginal population in Western Australia.MethodsWe identified all hospital records, between July 2004 and June 2012, with a discharge diagnosis code for all-cause gastroenteritis. Age-specific hospitalization rates for rotavirus and non-rotavirus acute gastroenteritis before and after the introduction of the rotavirus vaccination program were compared. Interrupted time-series models were used to examine differences in the annual trends of all-cause gastroenteritis hospitalization between the two periods.ResultsBetween July 2004 and June 2012, there were a total of 106,974 all-cause gastroenteritis-coded hospitalizations (1,381 rotavirus-coded [15% among Aboriginal] and 105,593 non-rotavirus gastroenteritis-coded [7% among Aboriginal]). Following rotavirus vaccination introduction, significant reductions in rotavirus-coded hospitalization rates were observed in all children aged <5 years (up to 79% among non-Aboriginal and up to 66% among Aboriginal). Among adults aged ≥65 years, rotavirus-coded hospitalizations were 89% (95% confidence interval, 16–187%) higher in the rotavirus vaccination program period. The time-series analysis suggested reductions in all-cause gastroenteritis hospitalizations in the post-vaccination period among both vaccinated and unvaccinated (age-ineligible) children, with increases observed in adults aged ≥45 years.ConclusionsRotavirus vaccination has been associated with a significant decline in gastroenteritis hospitalizations among children. The increase in the elderly requires further evaluation, including assessment of the cost-benefits of rotavirus vaccination in this population.
Highlights
Gastroenteritis is a leading cause of morbidity in young children worldwide in both developed and developing countries.[1]
This study aimed to describe the impact of the rotavirus vaccination program on the burden of hospitalizations associated with all-cause acute gastroenteritis in the Aboriginal and non-Aboriginal population in Western Australia
Hospitalization rates in the elderly were relatively low, a significant increase in hospitalization rates in the rotavirus vaccination period was observed among those aged ≥65 years (IRR 1.89; 95% confidence intervals (CIs), 1.16–2.87) in the non-Aboriginal population (Table 1)
Summary
Gastroenteritis is a leading cause of morbidity in young children worldwide in both developed and developing countries.[1]. Rotavirus is the most common cause of severe dehydrating gastroenteritis in young children.[4] Currently, two live attenuated oral rotavirus vaccines—a two-dose monovalent human rotavirus vaccine RV1 (Rotarix; GlaxoSmithKline Biologicals, Rixensart, Belgium), and a three-dose pentavalent human-bovine reassortant vaccine RV5 (RotaTeq; Merck Vaccines, Whitehouse Station, NJ, USA) have been licensed for use in Australia. Since July 2007, rotavirus vaccination has been included in Australia’s National Immunisation Program (NIP) for all children born on or after May 1, 2007.5 The programme in Western Australia provided RV1 at ages 2 and 4 months from July 2007, and switched to RV5 at ages 2, 4, and 6 months from July 2009. We aimed to assess the impact of the rotavirus vaccination program on the burden of hospitalizations associated with all-cause acute gastroenteritis (including rotavirus gastroenteritis and non-rotavirus gastroenteritis) in the Aboriginal and non-Aboriginal population in Western Australia
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