Rotavirus Vaccine Coverage Research Articles

Effects of Rotavirus Vaccination Coverage among Infants on Hospital Admission for Gastroenteritis across All Age Groups, Japan, 2011-2019.

We assessed the effect of rotavirus vaccination coverage on the number of inpatients with gastroenteritis of all ages in Japan. We identified patients admitted with all-cause gastroenteritis during 2011-2019 using data from the Diagnosis Procedure Combination system in Japan. We used generalized estimating equations with a Poisson distribution, using hospital codes as a cluster variable to estimate the impact of rotavirus vaccination coverage by prefecture on monthly numbers of inpatients with all-cause gastroenteritis. We analyzed 294,108 hospitalizations across 569 hospitals. Higher rotavirus vaccination coverage was associated with reduced gastroenteritis hospitalizations compared with the reference category of vaccination coverage <40% (e.g., for coverage >80%, adjusted incidence rate ratio was 0.87 [95% CI 0.83-0.90]). Our results show that achieving higher rotavirus vaccination coverage among infants could benefit the entire population by reducing overall hospitalizations for gastroenteritis for all age groups.

Vital Signs: Trends and Disparities in Childhood Vaccination Coverage by Vaccines for Children Program Eligibility - National Immunization Survey-Child, United States, 2012-2022.

The Vaccines for Children (VFC) program was established in 1994 to provide recommended vaccines at no cost to eligible children and help ensure that all U.S. children are protected from life-threatening vaccine-preventable diseases. CDC analyzed data from the 2012-2022 National Immunization Survey-Child (NIS-Child) to assess trends in vaccination coverage with ≥1 dose of measles, mumps, and rubella vaccine (MMR), 2-3 doses of rotavirus vaccine, and a combined 7-vaccine series, by VFC program eligibility status, and to examine differences in coverage among VFC-eligible children by sociodemographic characteristics. VFC eligibility was defined as meeting at least one of the following criteria: 1) American Indian or Alaska Native; 2) insured by Medicaid, Indian Health Service (IHS), or uninsured; or 3) ever received at least one vaccination at an IHS-operated center, Tribal health center, or urban Indian health care facility. Overall, approximately 52.2% of U.S. children were VFC eligible. Among VFC-eligible children born during 2011-2020, coverage by age 24 months was stable for ≥1 MMR dose (88.0%-89.9%) and the combined 7-vaccine series (61.4%-65.3%). Rotavirus vaccination coverage by age 8 months was 64.8%-71.1%, increasing by an average of 0.7 percentage points annually. Among all children born in 2020, coverage was 3.8 (≥1 MMR dose), 11.5 (2-3 doses of rotavirus vaccine), and 13.8 (combined 7-vaccine series) percentage points lower among VFC-eligible than among non-VFC-eligible children. Although the VFC program has played a vital role in increasing and maintaining high levels of childhood vaccination coverage for 30 years, gaps remain. Enhanced efforts must ensure that parents and guardians of VFC-eligible children are aware of, have confidence in, and are able to obtain all recommended vaccines for their children.

Pentavalent Rotavirus Vaccine Coverage and Trends in Rotavirus Detection Before and After This Vaccination in Chengdu, China.

Pentavalent rotavirus vaccine (RV5) coverage and changes in rotavirus detection in the prevaccine and postvaccine era in Chengdu were investigated. The results showed that the coverage of RV5 had been increasing but still relatively low. Nevertheless, the dramatical decline in the rotavirus detection was observed after the introduction of RV5. Efforts to improve the coverage of rotavirus vaccination should continue to maximize the public health benefits.

Enablers and barriers to rotavirus vaccine coverage in Assam, India- A qualitative study

BackgroundEstimates suggest that 78,000 children died due to rotavirus gastroenteritis annually between 2011 and 2013 in India. The north eastern state of Assam reported 38.4% pediatric diarrheal admissions testing positive for rotavirus. Rotavirus vaccine (RVV) was introduced in Assam in 2017 following which the National Family Health Survey-5 (NFHS-5) (2019) revealed low RVV coverage in Assam with wide variation between the districts. the current study was conceptualized and undertaken to capture the enablers and barriers to RVV coverage in Assam. MethodsQualitative study conducted in 5 randomly selected districts in Assam. Participants (key informants) were recruited by purposive sampling at each level of the health system including healthcare officials, service providers and caregivers based on availability. Thirty-five in-depth interviews (IDIs) and five focus group discussions (FGDs) were conducted. Interviews were tape recorded and transcribed. Data was coded and analyzed using the thematic framework approach. ResultsFindings from the qualitative data collection were collated and analyzed under 7 identified themes. Difficult terrain, limited service provider availability and no catch-up training for new recruits were some of the barriers to RVV coverage. In contrast, Information, Education & Communication (IEC) in vernacular language, RVV safety profile, development partner support and adequate RVV supply were identified as some of the enablers of RVV coverage. ConclusionFew broad recommendations to overcome identified barriers include comprehensive inter-sectoral coordination, regular monitoring and frequent refresher training sessions. There is a need for a future study utilizing existing coverage data and larger sample size to triangulate the findings of this study.

Rates and determinants of Rotavirus vaccine uptake among children in Italy: a cross-sectional study within the 2022 OBVIOUS* project

IntroductionThe World Health Organization defines rotavirus as among the most severe causes of viral gastroenteritis affecting children under 5 year old. Italy and other European countries do not release disaggregated data on rotavirus vaccination coverage. This study aimed to assess the uptake and drivers of rotavirus vaccination in Italy.MethodsWe administered a survey to 10,000 Italian citizens recruited via an online panel and proportionate to key demographic strata. We examined rotavirus vaccine uptake among parents whose youngest child was aged 6 weeks to 4 years, their sociodemographic characteristics, their beliefs about vaccine administration, and who recommended the rotavirus vaccination.ResultsA total of 711 respondents met the inclusion criteria for the rotavirus vaccine questionnaire. The uptake was estimated at 60.3% nationwide (66.4% among mothers and 50.2% among fathers). Being a mother and living in cities/suburbs was significantly associated with a higher likelihood of vaccine uptake, while fathers were more likely to be uncertain of their children’s vaccine status. Living in Central Italy and having friends/relatives opposed to vaccination were found to be significantly associated with a lower likelihood of vaccine uptake, while parents’ education level and children’s demographics were not found to correlate with any outcomes. In 90.3% of cases, the rotavirus vaccination was recalled as being recommended by a paediatrician.ConclusionsConsistent collection of behavioural preferences and socioeconomic characteristics of recipients of rotavirus vaccine campaigns, their epidemiological information, cost-benefit, and national policy data are crucial for designing effective vaccination strategies in Italy and other European countries with similar social profiles to reach the target uptake.

Co-administration with Men-B vaccine increases Rotavirus vaccination coverage: A 5-year regionwide retrospective cohort study (STORM study)

IntroductionIn Italy Rotavirus vaccination (RVV) is provided free of charge from 2018, however, the coverage is scattered and suboptimal. The narrow time frame to complete the schedule is a barrier to uptake, and co-administration with other vaccines may potentially increase the coverage. Although the co-administration of RV vaccine and Meningococcal Group B vaccine (MenB) is not included in the product labels, we aimed at studying its impact on RVV coverage. MethodsThis Surveillance study on Timing and cOverage of Rotavirus and MenB vaccine co-administration (STORM study) used the Regional Vaccination Registry to collect data about children born in Campania Region between January 2016 and December 2020, and receiving vaccines scheduled in the first year of life. ResultsAmong the 224,110 children enrolled, 60,614 (27.0%) completed the RVV schedule, with a vaccination rate that increased over time from 1.15% in 2016 to 56.92% in 2020.The first and last dose of RVV schedule were administered beyond the recommended time in 6% of the study population, respectively.Co-administration of RV vaccine with MenB vaccine increased from 0.7 % in 2016 to 46.85 % in 2020. Children receiving RV/MenB vaccines concomitantly had a significantly higher chance of completing the RV schedule compared to those receiving RVV alone during a specific appointment (94.78 % vs 72.26 %, Prevalence Ratio -PR- 1.275, 95 %CI 1.245–1.295p < 0.00001). The positive driving effect of RV/MenB co-administration was more evident for children receiving pentavalent (PR 1.288) than monovalent RVV (PR 1.115) which was confirmed when adjusted for confounding variables (i.e., year of vaccination, local district, gender). ConclusionsAlthough still far from the target, RVV coverage has increased in recent years in Campania Region. Co-administration with MenB vaccine may aid in increasing RVV coverage, especially for pentavalent RVV. Further safety data are needed to support co-administration as a key tool to increase coverage.

Rotavirus vaccination coverage before and during the covid-19 pandemic in Fako division, Cameroon

Background: Rotavirus vaccines aim to reduce morbidity and mortality associated with severe gastroenteritis. Repeat infections are common but less severe than the primary infection. Rotarix vaccine is given orally in two doses at 2 and 4 months of age in Cameroon. Rotavirus remained a threat to the health of young children during the COVID-19 pandemic and many parts of the world witnessed a decline in vaccine coverage during this pandemic. We sought to find out If the story was the same in Fako Diivision, Cameroon, amidst a sociopolitical conflict. Methods: A retrospective study was done in 4 hospitals on Rotavirus immunization records of children under 5 from 2016-2022. Stratified sampling used, descriptive stats reported. Differences evaluated with Pearson’s chi square (P&lt;0.05).

The impact of rotavirus vaccination on acute diarrhea in Thai children under 5 years of age in the first year of universal implementation of rotavirus vaccines in the National Immunization Program (NIP) in Thailand: a 6-year analysis

BackgroundTwo types of rotavirus vaccines (RVs), Rotarix (RV1) and RotaTeq (RV5), were licensed as optional vaccines in 2012 and became part of the National Immunization Program (NIP) in the fiscal year 2020 in Thailand. The main objective was to evaluate the impact of rotavirus vaccines on the burden of acute diarrheal severity ranging from outpatient visits, diarrheal-related admission or deaths in the pre-NIP period (fiscal year 2015–2019) and in the fiscal year 2020. The minor objectives were assessed on the monthly admission rate, rotavirus vaccine coverage rate and rotavirus vaccine completed dose (RotaC).MethodsData regarding OPD, admission, and death cases under the Thailand National Health Coverage (NHC) from fiscal year 2015–2020, which were recorded as International Classification of Diseases and Related Health Problem 10th (ICD-10), were analyzed.ResultsThe burden of diarrheal-related disease diminished after the rotavirus vaccine was introduced in the fiscal year 2020 when compared to the previous 5 fiscal years.The OPD visit rate decreased from 10.1 to 8.3 visits per 100 person-years (P < 0.001), or a 17.8% reduction (incidence rate ratio (IRR) = 0.82; 95% confidence interval (CI): 0.81 to 0.82). The admission rate significantly declined from 31.4 to 30.5 cases per 1,000 person-years, (P < 0.001), or a 2.9% reduction (IRR = 0.97; 95% CI: 0.96 to 0.98). The diarrheal-related mortality rate also subsided from 10.2 to 8.1 cases per 100,000 person-years (P 0.3), or a 20.0% reduction (IRR = 0.88; 95% CI: 0.50 to 1.22). The major population in both admissions and deaths was infants under 1 year of age (P < 0.001). Seasonality was seen as a constant bimodal pattern, with a significant decrease in monthly admissions after 6 months of rotavirus vaccine introduction to NIP (P < 0.001). RotaC was 37.4% in the first year of NIP.ConclusionsThe rotavirus vaccine had a potential benefit for reducing the diarrheal disease burden, especially in infants under one year of age. Seasonality outbreaks of acute diarrhea subsided after the rotavirus vaccine was introduced. The RotaC was fairly low in the first year of the NIP. The quality of the rotavirus vaccine should be warranted.Trial registrationNumber TCTR20220120003, date of registration: 20/01/2022, site: Thai Clinical Trials Registry.

Deployment of Rotavirus Vaccine in Western Kenya Coincides with a Reduction in All-Cause Child Mortality: A Retrospective Cohort Study.

Rotavirus is an important cause of fatal pediatric diarrhea worldwide. Many national immunization programs began adding rotavirus vaccine following a 2009 World Health Organization recommendation. Kenya added rotavirus vaccine to their immunization program at the end of 2014. From a cohort of 38,463 children in the Kisumu health and demographic surveillance site in western Kenya, we assessed how the implementation of the rotavirus vaccine affected mortality in children under 3 years of age. Following its introduction in late 2014, the span of rotavirus vaccine coverage for children increased to 75% by 2017. Receiving the rotavirus vaccine was associated with a 44% reduction in all-cause child mortality (95% confidence interval = 28-68%, p < 0.0001), but not diarrhea-specific mortality (p = 0.401). All-cause child mortality declined 2% per month following the implementation of the rotavirus vaccine (p = 0.002) among both vaccinated and unvaccinated children, but diarrhea-specific mortality was not associated with the implementation of the rotavirus vaccine independent of individual vaccine status (p = 0.125). The incidence of acute diarrhea decreased over the study period, and the introduction of the rotavirus vaccine was not associated with population-wide trends (p = 0.452). The receipt of the rotavirus vaccine was associated with a 34% reduction in the incidence of diarrhea (95% confidence interval = 24-43% reduction). These results suggest that rotavirus vaccine may have had an impact on all-cause child mortality. The analyses of diarrhea-specific mortality were limited by relatively few deaths (n = 57), as others have found a strong reduction in diarrhea-specific mortality. Selection bias may have played a part in these results-children receiving rotavirus vaccine were more likely to be fully immunized than children not receiving the rotavirus vaccine.

Estimating global and regional between-country inequality in routine childhood vaccine coverage in 195 countries and territories from 2019 to 2021: a longitudinal study.

Global routine childhood vaccine coverage has plateaued in recent years, and the COVID-19 pandemic further disrupted immunisation services. We estimated global and regional inequality of routine childhood vaccine coverage from 2019 to 2021, particularly assessing the impacts of the COVID-19 pandemic. We used longitudinal data for 11 routine childhood vaccines from the WHO-UNICEF Estimates of National Immunization Coverage (WUENIC), including 195 countries and territories in 2019-2021. The slope index of inequality (SII) and relative index of inequality (RII) of each vaccine were calculated through linear regression to express the difference in coverage between the top and bottom 20% of countries at the global and regional levels. We also explored inequalities of routine childhood vaccine coverage by WHO regions and unvaccinated children by income groups. Globally between January 1, 2019 and December 31, 2021, most childhood vaccines showed a declining trend in coverage, and therefore an increasing number of unvaccinated children, especially in low-income and lower-middle-income countries. Between-country inequalities existed for all 11 routine childhood vaccine coverage indicators. The SII for the third dose of diphtheria-tetanus-pertussis-containing vaccine (DTP3) coverage was 20.1 percentage points (95% confidence interval: 13.7, 26.5) in 2019, and rose to 23.6 (17.5, 30.0) in 2020 and 26.9 (20.0, 33.8) in 2021. Similar patterns were found for RII results and in other routine vaccines. In 2021, the second dose of measles-containing vaccine (MCV2) coverage had the highest global absolute inequality (31.2, [21.5-40.8]), and completed rotavirus vaccine (RotaC) coverage had the lowest (7.8, [-3.9, 19.5]). Among six WHO regions, the European Region consistently had the lowest inequalities, and the Western Pacific Region had the largest inequalities for many indicators, although both increased from 2019 to2021. Global and regional inequalities of routine childhood vaccine coverage persisted and substantially increased from 2019 to 2021. These findings reveal economic-related inequalities by vaccines, regions, and countries, and underscore the importance of reducing such inequalities. These inequalities were widened during the COVID-19 pandemic, resulting in even lower coverage and more unvaccinated children in low-income countries. Bill & Melinda Gates Foundation.

A health surveillance data-based assessment of the impact of routine paediatric rotavirus vaccination on all-cause acute childhood diarrhoea

Background: To improve the fight against faecal-orally transmitted rotavirus infection, which is the leading cause of severe diarrhoea among children aged &lt; 5 years, Ghana has incorporated rotavirus vaccination into its expanded programme of immunization. Rotavirus diarrhoea constitutes a significant portion of all-cause acute childhood diarrhoea (ACD) in children. Objective: This study was designed to investigate the impact of routine rotavirus vaccination on ACD cases. Methods: The study was completed through a cross-sectional review of health institutional childhood diarrhoea surveillance data from 2012 to 2021, which includes the year when rotavirus vaccination was introduced. The study dataset was abstracted from the DHIMS-2 internet-based health data repository and was descriptively analyzed by administrative regions using Epi InfoTM version 3.5.1(CDC, USA). Results: The burden of ACD in terms of both absolute and mean values remained the lowest among infants aged under 28 days across all regions, as they had not yet received rotavirus vaccination. In contrast, children aged 1 to 4 years, who are typically exposed to rotavirus serotypes 1 and 2, consistently experienced the highest burden of ACD. With increasing rotavirus vaccination coverage, children aged 1 month to 4 years recorded a marginal, but sustained decline in mean ACD cases from 2016 to 2021. The ACD also similarly declined slowly among the rotavirus vaccine naïve infants aged &lt; 28 days. Despite a spike in 2017, the burden of ACD was low in the Ahafo administrative region. However, increasing rotavirus vaccination coverage did not appear to have a significant impact on reducing ACD in the Ashanti, Bono, Bono East, Eastern, and Northeast administrative regions. From 2012 to 2021, the Central, Greater Accra, Oti, Upper East, Volta, and Western administrative regions recorded a marginal decline in the burden of ACD among children aged 1 to 4 years, and this was accompanied by an increase in rotavirus vaccination coverage. The ACD cases rose as rotavirus vaccination coverage decreased in the Western North Region between 2015 and 2019. Conclusion: Routine rotavirus vaccination may have contributed to a reduction in severe childhood ACD cases even though this study cannot exclude the impact of other anti-diarrhoeal interventions. To evaluate the population effectiveness of rotavirus vaccines, it is recommended to widely promote routine rotavirus disease surveys, which can be nested within ACD surveillance.

Co-administration of vaccines against rotavirus and group b meningococcus is associated with an increased rotavirus vaccination coverage: a 5-year retrospective population study

Co-administration of vaccines against rotavirus and group b meningococcus is associated with an increased rotavirus vaccination coverage: a 5-year retrospective population study

The Full Impact of Rotavirus Vaccines in Africa Has Yet to Be Realized.

Africa bears the brunt of diarrheal mortality globally. Rotavirus vaccination rates are high across the continent and demonstrate impact on diarrheal disease reduction. Nevertheless, there is room for significant improvement in managing rotavirus vaccine coverage, in access to recognized public services such as appropriate medical care, including oral rehydration therapy and improved water and sanitation.

Acute diarrheal diseases and their relationship with water quality in Araguatins, Tocantins, Brazil: a cross-sectional study

Diarrhea remains a significant cause of death worldwide among children under five years old. In Brazil, the highest incidence of the disease occurs in the north region, and the epidemiological characteristics of diarrhea in Araguatins, TO, northern Brazil, have not been reported. The present study aimed to analyze the occurrence of acute diarrheal diseases (ADD) in Araguatins between 2014 and 2019 and its relationship with the quality of the public water supply. The study also analyzed the correlation between ADD frequency and rotavirus vaccination coverage of children. The data were obtained from the Brazilian Ministry of Health (SIVEP-DDA database) and the Health Surveillance Agency of Araguatins. The reported cases of acute diarrheal diseases significantly increased in 2018 and 2019 compared to the other years, and the occurrence of greater severity in the age group of ³10 years increased in the same period. The highest incidence of diarrhea occurred in 2018 when the application of rotavirus vaccines to children was the lowest. In most years investigated, the cases of acute diarrheal diseases occurred in both rainy and dry periods. However, in 2016, diarrhea cases were concentrated in the dry period, and Escherichia coli and total coliforms were found more frequently in the public water supply. The highest frequency of contamination with E. coli and total coliforms occurred in the Downtown area. The conclusion was that diarrheal disease may be caused, at least partially, by water-conveying agents in the treated public water supply of the Araguatins.

Change in Rotavirus Vaccine Coverage in Brazil from before (2015-2019) through the COVID-19 Pandemic Period (2020-2021).

During the COVID-19 pandemic, a reduction in vaccination coverage of children and adolescents was observed in several countries. The aim of this study was to assess the impact of the pandemic, in the first two years, on human rotavirus vaccine (HRV) coverage in Brazil compared with previous years. The number of doses of HRV administered in the period from January 2015 to December 2021 and its annual vaccination coverage were analyzed. The vaccination coverage decreased to 77.3% in 2020 and to 70.4% in 2021, substantially lower than the minimum that would be expected (89.2%); the decline was more pronounced in the second year of the pandemic despite the fact that in this period, the circulation restrictions were already less tight. Of the five Brazilian macro-regions, the northeast had the largest decline, and the south had the smallest impact on coverage. At the municipal level, less than half of the Brazilian municipalities managed to achieve vaccination coverage above 90% in either pandemic year. Although there was already a downward trend in coverage in the pre-pandemic years, the present study shows that the values recorded in 2020 and 2021 were significantly lower. Monitoring of vaccination coverage in the coming years should be carried out continuously in order to avoid a possible resurgence of rotavirus-induced diarrhea.

Vaccination coverage in children under one year of age and associated socioeconomic factors: maps of spatial heterogeneity.

to analyze vaccination coverage spatial distribution in children under one year old and the socioeconomic factors associated with meeting the recommended goals in Minas Gerais. an ecological study, carried out in 853 municipalities in the state. Pentavalent, poliomyelitis, meningococcal conjugate, yellow fever, rotavirus, and 10-valent pneumococcal conjugate vaccination coverage were analyzed. Scan statistics and multiple logistic regression were performed to identify spatial clusters and factors associated with meeting coverage goals. spatial analysis revealed clusters with risk of low coverage for all vaccines. Number of families with per capita income of up to 1/2 wage, Minas Gerais Social Responsibility Index and percentage of the poor or extremely poor population were associated with meeting the established goals. the results are useful for designing interventions regarding the structuring of vaccination services and the implementation of actions to increase vaccination coverage in clusters with less propensity to vaccinate.

The Value of Rotavirus Vaccination in Europe: A Call for Action.

The severe acute respiratory syndrome coronavirus2 (SARS-CoV-2) pandemic has pushed many healthcare systems into crisis. High vaccine coverage amongst children reduces emergency room presentations, hospital admissions and deaths due to vaccine-preventable diseases, freeing up healthcare resources including polymerase chain reaction testing for patients with SARS-CoV-2. In Europe, rotavirus gastroenteritis leads to 75,000-150,000 hospitalisations and up to 600,000 medical encounters annually. Nevertheless, in 2022, only 18 countries in Europe (out of 38) have a publicly funded routine universal mass immunisation programme against rotavirus gastroenteritis. Evidence available in the last few years re-emphasises that rotavirus vaccines currently available in Europe are highly effective, preventing up to 96% of rotavirus-related hospitalisations in children less than 1year of age (potentially 72,000-144,000 hospitalisations Europe-wide). Long-term surveillance indicates that rotavirus vaccination does not result in an overall increase in intussusception. On the contrary, increasing evidence suggests an overall reduction in intussusception in the first 12months of life when early, high rotavirus vaccine coverage is achieved. Prevention of rotavirus gastroenteritis has marked positive impacts on parental wages and government tax revenue, with benefits extending across the whole economy. In the SARS-CoV-2 pandemic setting there is a new imperative to achieve high levels of paediatric vaccination against vaccine-preventable diseases, including rotavirus gastroenteritis. The introduction of rotavirus universal mass vaccination can be expected to reduce the number of preventable illnesses, hospitalisations and deaths caused by rotavirus gastroenteritis. Reducing vaccine-preventable diseases is particularly urgent at this time when healthcare systems are preoccupied and overwhelmed with SARS-CoV-2. Graphical abstract available for this article.

Aetiology and incidence of diarrhoea requiring hospitalisation in children under 5 years of age in 28 low-income and middle-income countries: findings from the Global Pediatric Diarrhea Surveillance network

IntroductionDiarrhoea remains a leading cause of child morbidity and mortality. Systematically collected and analysed data on the aetiology of hospitalised diarrhoea in low-income and middle-income countries are needed to prioritise...

Prevalence of viral gastroenteritis pathogens among hospitalized children under 5 year of age in the process of introducing the RV vaccine in the routine immunization

Rotavirus (RV), Norovirus (NV), Sapovirus (SaV) and Astrovirus (Ast) are the leading causes of gastroenteritis and mortality in children worldwide. RV vaccines help to reduce the burden of diarrhea while the importance of other viruses is increasing. Therefore, we conducted a cross-sectional descriptive study to determine prevalence of these viruses in hospitalized children under 5 years old in Nam Dinh province with approximately 80% of RV vaccine coverage. We randomly selected 579 (25%) among diarrheal samples collected in 4 district hospitals from Dec. 2017 to Nov. 2019. An ELISA kit was employed to detect RV and the multiplex real-time RT-PCR with specific primers to detect NV, SaV and Ast. These viruses were found among 64.3% of hospitalized children, of which NV and RV were present in 28.5% and 21.4%, respectively, while SaV and Ast were detected in 3.3% and 2.6%, respectively. Co-infections accounted for 8.5%, mainly among RV and 3 other viruses. There is a significant difference in RV and NV positive rates between vaccinated and unvaccinated groups (p &lt; 0.001 and p = 0.008, respectively). This study contributed to the understanding of the potential impact of rotavirus vaccine on other diarheal pathogens and emphasize the need for further epidemiological studies when the nationwide RV vaccination in Vietnam is implementing.

Major Changes in Spatiotemporal Trends of US Rotavirus Laboratory Detections After Rotavirus Vaccine Introduction-2009-2021.

For the 15 years before rotavirus vaccine introduction in 2006, annual rotavirus activity in the United States showed a distinct spatiotemporal pattern, peaking first in the Southwest and last in the Northeast. We modeled spatiotemporal trends in rotavirus laboratory detections from 2009 to 2021. Laboratories reporting to the National Respiratory and Enteric Virus Surveillance System were eligible for inclusion in a given surveillance year (July to June) if ≥1 polymerase chain reaction or enzyme immunoassay rotavirus test per week was reported during ≥26 weeks and totaling ≥100 annual tests. For each laboratory, the season peak was the week with the highest 7-week moving average of the number of rotavirus positive tests during the national season, defined as the period with a 3-week moving average of >10% rotavirus positivity lasting ≥2 consecutive weeks. We input peak week as a continuous variable and the geospatial coordinates of each laboratory into a spherical variogram model for Kriging spatial interpolation. We also created a state-level bivariate choropleth map using tertiles of the 2010-2019 average birth rates and rotavirus vaccine coverage. Following the established biennial trend, the 2010-2011, 2012-2013, 2014-2015, 2016-2017, and 2018-2019 surveillance years had >10% rotavirus positivity for ≥2 weeks and were included in the geospatial analysis. During all 5 seasons included in the geospatial analysis, the earliest peak week occurred in Oklahoma, Arkansas, and the western Gulf coast, a pattern markedly different from prevaccine seasons. These states also had the average lowest rotavirus vaccine coverage and highest birth rate, suggesting that more rapid accumulation of susceptible children drives annual rotavirus season activity. Increasing vaccine coverage remains a key tool in reducing rotavirus burden.