Abstract
Introduction: Rotavirus remains a common cause of severe
gastroenteritis, resulting in hospitalization of about 5 per 10,000
children in the U.S. each year. Available rotavirus vaccines,
although effective, are underused compared with other routine
childhood vaccines. Receipt of other routine childhood
immunizations, such as DTaP or PCV, at 2 and 4 months of age among
children unvaccinated for rotavirus indicates a missed opportunity
to simultaneously vaccinate for rotavirus. In this study, we
analyzed missed opportunities for rotavirus vaccination in children
included in the 2014 National Immunization Survey. Methods: All
analyses were conducted using data from the 2014 National
Immunization Survey (NIS) available from the Centers for Disease
Control and Prevention (CDC). We classified missed opportunities
for rotavirus vaccination according to the ACIP and WHO rotavirus
vaccine recommendations. Doses of DTaP vaccine received from 6
weeks through 7 months and 6 days of age were considered missed
opportunities for rotavirus vaccine according to ACIP guidelines.
Doses of DTaP or MMR received from 6 weeks to 24 months of age were
considered missed opportunities for any dose of rotavirus vaccine
according to the World Health Organization recommendation. Results:
Seventy-one percent of children in the 2014 NIS were vaccinated for
rotavirus. Among the 14% of children unvaccinated for rotavirus,
72% had ≥ 1 ACIP-defined
missed opportunity to receive rotavirus vaccine and 63% had
≥2 missed opportunities.
Among children unvaccinated for rotavirus, 83% had
≥1 WHO-defined missed
opportunity to receive rotavirus vaccine and 75% had
≥2 missed opportunities.
We found that complete rotavirus vaccine coverage may be improved
from 71% to 81% if all missed opportunities within the ACIP-
recommended schedule were used. Additionally, we found that 97%
complete coverage would be achievable if rotavirus vaccine were
given simultaneously with DTaP or MMR through 24 months of age.
Conclusion: Addressing missed opportunities for rotavirus
vaccination may be an important step towards achieving 80%
rotavirus vaccine coverage, the target outlined by Healthy People
2020. Although expanding the window for rotavirus vaccination
through 24 months of age may provide an opportunity to increase
coverage, safety concerns may prohibit use of this option in the
U.S.
Table of Contents
1. Chapter I: Background/Literature Review 2. Chapter II:
Manuscript A. Introduction B. Methods C. Results D. Discussion F.
Tables 1-4 G. Figure 1 3. Chapter III: Summary, Public Health
Implications, Possible Future Directions 4. References
About this Master's Thesis
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