Rotavirus Vaccines and Health Care Utilization for Rotavirus and Diarrhea in the United States (2007-2014) Public

Abstract

In the United States, prior to the introduction of rotavirus vaccine in 2006, rotavirus caused an estimated 20 to 60 deaths, 55,000 to 70,000 hospitalizations, 205,000 to 272,000 emergency department visits, and 410,000 outpatient visits annually. There are two rotavirus vaccines currently available in the United States: RotaTeq (RV5) and Rotarix (RV1). METHODS: This was a retrospective cohort study using data from the 2001-2014 Truven Health Marketscan Commercial Claims and Encounters Database, with commercially insured US children under 5 years of age. We assessed annual RV5 and RV1 rotavirus vaccine coverage and compared rates of diarrhea-associated health care utilization in prevaccine (2001–2006) versus post-vaccine introduction (2007–2014) years. We also examined vaccine effectiveness (VE) and duration of protection by comparing rates of diarrhea-associated health care utilization in vaccinated versus unvaccinated children. RESULTS: In the cohort of > 308,000 children <5 years of age, 69% had received at least 1 dose of RV5 and 13% had received at least 1 dose of RV1 by December 31, 2013. Compared with the average rate of rotavirus-coded hospitalizations in the prevaccine years (2001–2006), rates were reduced by 75% in 2007–2008, 60% in 2008–2009, 94% in 2009–2010, 80% in 2010–2011, 97% in 2011–2012, 88% in 2012–2013, and 98% in 2013–2014. The overall, adjusted vaccine effectiveness estimates for RV5 were 87% (95% CI: 85%, 89%) among 3 to 11 months of age, 87% (95% CI: 85%, 89%) in 12 to 23 months of age, 88% (95% CI: 85%,90%) in 24 to 35 months of age and 88% (95% CI: 85%, 90%) in 36 to 47 months of age, and 88% (95% CI: 85%, 90%) in 48 to 59 months of age. The adjusted VE was 88% (95% CI: 80%, 93%) for RV1 among 3 to 11 months of age, 88% (95% CI: 79%, 93%) in 12 to 23 months of age and 88% (95% CI: 80%, 93%) in 24 to 35 months of age. CONCLUSION: Implementation of rotavirus vaccines has substantially reduced rotavirus and diarrhea health care utilization in US children under 5 years of age.

Table of Contents

Introduction 1

Background 2

Methods 4

Results 8

Discussion 16

References 20

About this Master's Thesis

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School	Rollins School of Public Health
Department	Executive Masters of Public Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Epidemiology
Mot-clé	Rotavirus Vaccines Diarrhea
Committee Chair / Thesis Advisor	Lopman, Ben, Emory University
Partnering Agencies	CDC

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