Publication

A decade of experience with rotavirus vaccination in the United States – vaccine uptake, effectiveness, and impact

Authored by:

Pindyck T, Tate JE, Parashar UD

Full Citation:

Pindyck T, Tate JE, Parashar UD 2018. A decade of experience with rotavirus vaccination in the United States – vaccine uptake, effectiveness, and impact. Expert Review of Vaccines. 17(7).

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Additional key concepts from this publication:

Immunization can decrease hospital admissions, thus alleviating pressure on overburdened health systems.

Key Evidence: Prior to the introduction of rotavirus vaccines in the U.S., there were an estimated 205,000 – 272,000 emergency department visits and 55,000 – 70,000 hospitalizations due to rotavirus in children each year. A series of studies found that hospitalizations in children under five due to rotavirus declined, on average by 80% from the pre-vaccine to the post-vaccine era, while both outpatient visits and emergency department visits due to rotavirus declined 57%.

Studies have shown that poorer children tend to be vaccinated at lower rates than wealthier children.

Key Evidence: Children in U.S. families living below the poverty line have significantly lower rotavirus vaccination rates than children at or above the poverty line (67% vs. 77%).

Children of less educated parents are less likely to have complete or timely immunizations.

Key Evidence: Children in the U.S. whose mothers were not educated beyond high school have significantly lower vaccination rates for rotavirus than children of mothers with advanced degrees (68% vs. 84%).

Use of vaccines, including strengthening existing immunization programs, provides opportunities for significant reductions in disease burden with resultant economic benefits.

Key Evidence: A study of insurance claims in the U.S. for children under five estimated that, from 2007 to 2011, rotavirus vaccination prevented more than 176,000 hospitalizations, 242,000 emergency room visits and more than 1.1 million outpatient visits due to diarrhea — saving an estimated $924 million in direct health care costs over four years.

Vaccination programs such as those for Rotavirus have shown a significant short-term return on investment.

Key Evidence: A series of studies in the U.S. estimated that the average savings in direct healthcare costs from rotavirus and acute gastroenteritis were between $121 million and $231 million per year once rotavirus vaccines were introduced.

Immunization can help protect unimmunized children, adults and the elderly through herd effects.

Key Evidence: Several studies in the U.S. have shown that hospitalizations due to rotavirus fell sharply in children too old to be vaccinated as well as in adults after rotavirus vaccines were introduced, indicating herd protection. In one large study, rotavirus hospitalizations in 2008 — two years after the first vaccine was introduced — declined by 71% in 5-14 year old children and by 65% in 15-24 year olds compared to the pre-vaccine period.

From the VoICE Editors: For more information also see Lopman 2011. https://academic.oup.com/jid/article/204/7/980/810889