Rotavirus vaccine and health care utilization for diarrhea in U.S. children

January 01, 0001

Rotavirus vaccine and health care utilization for diarrhea in U.S. children

Routine vaccination of U.S. infants with pentavalent rotavirus vaccine (RV5) began in 2006. Using MarketScan databases, these US authors assessed RV5 coverage and diarrhea-associated health care use from July 2007 through June 2009 versus July 2001 through June 2006 in children under 5 years of age. They compared the rates of diarrhea-associated health care use in unvaccinated children in the period from January through June (when rotavirus is most prevalent) in 2008 and 2009 with the prevaccine rates to estimate indirect benefits. They estimated national reductions in the number of hospitalizations for diarrhea, and associated costs, by extrapolation.

They found: "By December 31, 2008, at least one dose of RV5 had been administered in 73% of children under 1 year of age, 64% of children 1 year of age, and 8% of children 2 to 4 years of age. Among children under 5 years of age, rates of hospitalization for diarrhea in 2001-2006, 2007-2008, and 2008-2009 were 52, 35, and 39 cases per 10,000 person-years, respectively, for relative reductions from 2001-2006 by 33% in 2007-2008 and by 25% in 2008-2009; rates of hospitalization specifically coded for rotavirus infection were 14, 4, and 6 cases per 10,000 person-years, respectively, for relative reductions in the rate from 2001-2006 by 75 in 2007-2008 and by 60% in 2008-2009. In the January-June periods of 2008 and 2009, the respective relative rate reductions among vaccinated children as compared with unvaccinated children were as follows: hospitalization for diarrhea, 44% and 58%; rotavirus-coded hospitalization, 89% and 89%; emergency department visits for diarrhea, 37% and 48%; and outpatient visits for diarrhea, 9% and 12%. Indirect benefits (in unvaccinated children) were seen in 2007-2008 but not in 2008-2009. Nationally, for the 2007-2009 period, there was an estimated reduction of 64,855 hospitalizations, saving approximately $278 million in treatment costs."

The authors concluded: "Since the introduction of rotavirus vaccine, diarrhea-associated health care utilization and medical expenditures for U.S. children have decreased substantially."

It would be nice to know the estimated vaccination costs to balance the cost-effectiveness equation.

For the full abstract, click here.

N Engl J Med 365:1108-1117, 22 September 2011 © 2011 to the Massachusetts Medical Society
Rotavirus Vaccine and Health Care Utilization for Diarrhea in U.S. Children. Jennifer E. Cortes, Aaron T. Curns, Jacqueline E. Tate, et al. Correspondence to Dr. Parashar: [email protected]

Category: Keywords: rotavirus, vaccination, children, diarrhea, hospital admissions, outcomes study, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 4 October 2011

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