ROTAVIRUS VACCINATION OF INFANTS MAY REDUCE ACUTE GASTROENTERITIS RATES IN THE ELDERLY IN ENGLAND

Abstract

Rotavirus is the main cause of severe acute gastroenteritis (AGE) in children under 5 but has not been considered an important cause of AGE in the elderly. This study aims to evaluate the impact of rotavirus infant vaccination introduction in the UK on all cause AGE episodes in primary care across all age groups using the Clinical Practice Research Datalink (CPRD) database. We included all persons registered in CPRD between 1st July 2010 and 30th June 2016. Cut-off date to define pre- and post-vaccination periods was 1st July 2013. AGE GP episodes were defined using AGE related Read codes. We calculated crude AGE episode rates, overall and stratified per age group and calendar time. Overall, there were 29 AGE episodes per 1,000 person-years in the pre-vaccination period compared to 24 post-vaccination (18.3% reduction, 95% CI: 17.7–18.8). The largest decrease was observed in children < 5 years (27.4% reduction, 95% CI 26.4 – 28.4). However, a significant decrease was also observed among the elderly, particularly among 65 to 74 year olds: from 29 to 24 AGE episodes per 1,000, a 16.7% (95% CI: 14.9–18.4) decrease. AGE episode rates in this age group in the 3 years prior to vaccine introduction were stable between 28 and 29 AGE episodes per 1,000. This ecological analysis suggests that the introduction of rotavirus vaccination in the UK may have resulted in a significant impact on all cause AGE episodes among the elderly, similar to what has been seen following the introduction of pneumococcal vaccination among infants.