Abstract
In 2008, the National Advisory Committee on Immunization recommended routine rotavirus immunizations in healthy Canadian infants. Over the following seven years, eight provinces and two territories introduced the rotavirus vaccine into their publicly funded immunization programs. Assess the burden of rotavirus infections before and after implementation of publicly funded immunization programs. We analyzed laboratory-confirmed community cases of rotavirus reported to the National Enteric Surveillance Program and hospitalizations of children younger than three years old from 2007 to 2017 with rotavirus diagnosis-specific ICD-10 codes. Rates of illness were calculated for each province for the two years prior to and after implementation of public funding of the vaccine. The year of implementation was not included to accommodate the uptake period of the vaccine. Age-specific rates were assessed in jurisdictions where five years of data were available the year after the vaccine was publicly funded. The pre-post and difference-in-difference (DID) methodologies were applied to hospital discharge data to evaluate changes between the funding and non-funding jurisdictions. Community cases of laboratory-confirmed rotavirus infection reported to the National Enteric Surveillance Program declined by 54% between 2010 and 2017. Rates of hospital discharges decreased significantly among children in six provinces after the adoption of the rotavirus vaccine. Hospital discharge rates in Alberta, Manitoba, Ontario and Prince Edward Island dropped between 53% and 71%, and by 75% for British Columbia and Saskatchewan. Public funding of the rotavirus vaccine appeared to lead to significant reductions in laboratory-confirmed rotavirus cases reported to the National Enteric Surveillance Program and in the rates of rotavirus gastroenteritis-related hospital discharges.
Highlights
Rotavirus is a common, infectious disease transmitted from person to person via the fecal–oral route
Public funding of the rotavirus vaccine appeared to lead to significant reductions in laboratory-confirmed rotavirus cases reported to the National Enteric Surveillance Program and in the rates of rotavirus gastroenteritis-related hospital discharges
National Enteric Surveillance Program data – community rotavirus infections We summarized national counts of rotavirus laboratory cases reported to NESP by the participating provinces weekly and annually to reflect general reporting trends of community cases
Summary
Infectious disease transmitted from person to person via the fecal–oral route. In the pre-vaccine era, most children experienced an infection by the time they had reached five years old. Based on limited available data, Thomas et al estimated that between 2000 and 2010 an average of 850,233 cases of community rotavirus occurred each year in Canada [1]. From asymptomatic infection to severe disease that can lead to severe dehydration and death. Immunocompromised children are at an increased risk of severe, prolonged and even fatal rotavirus infections [2]. In most healthy Canadian children, the illness is self-limiting and rarely results in long-term sequelae or death. In 2008, the National Advisory Committee on Immunization recommended routine rotavirus immunizations in healthy Canadian infants. Over the following seven years, eight provinces and two territories introduced the rotavirus vaccine into their publicly funded immunization programs
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