Clinic Visits, Costs Decreased by Rotavirus Vaccination in US Children

Children in the United States who received rotavirus vaccination (Rotarix, GlaxoSmithKline Biologicals [RV1]) were found to have a lower risk for first infection with rotavirus, fewer rotavirus-related and diarrhea-related clinic visits, and lower costs for first rotavirus or first diarrhea episode compared with unvaccinated children, according to a recent study published in Vaccine.

In this observational study, children born between 2007 and 2011 (n=225,587) from a commercial insurance database were categorized as completely vaccinated (2 doses of RV1; n=34,928), incompletely vaccinated (1 dose of RV1; n=8390), or unvaccinated (no vaccine or RotaTeq, Merck & Co, Inc [RV5]; n=182,269).

Rates of rotavirus-related healthcare encounters and costs were monitored with insurance claim information.

Compared with unvaccinated children, the incidence of first rotavirus episode was lower for the complete vaccination group (incidence rate ratio [IRR], 0.17; 95% CI, 0.09-0.30) and the incomplete vaccination group (IRR, 0.19; 95% CI, 0.06-0.58).

Similarly, fully vaccinated children had fewer rotavirus-related inpatient visits (IRR, 0.07; 95% CI, 0.02-0.21), outpatient visits (IRR, 0.25; 95% CI, 0.11-0.54), and emergency room visits (IRR, 0.09; 95% CI, 0.03-0.32).

The researchers also found that the complete vaccination and incomplete vaccination groups had significantly lower resource use for rotavirus-related inpatient visits and emergency room visits compared with unvaccinated children.

Only the complete vaccination group was significantly different from the unvaccinated group for outpatient visits. For diarrhea-related visits, children with complete vaccination had lower rates of inpatient and emergency room visits; children with incomplete vaccination only had lower rates of emergency room visits.

For completely vaccinated children, the adjusted mean cost for the first rotavirus episode per 1000 persons was $11,511 less than unvaccinated children. Similarly, the adjusted mean cost for the first diarrhea episode per 1000 persons was $46,772 less than completely vaccinated children.

“Given the effectiveness of RV1 vaccination and [rotavirus] vaccination in general, efforts should focus on improving [rotavirus] vaccination rates, which lag behind most pediatric vaccination rates and continue to fall below the Healthy People 2020 target of 80%,” the authors concluded.

Reference

Krishnarajah G, Kageleiry A, Korves C, Lefebvre P, Duh MS. Public health impact of Rotarix vaccination among commercially insured children in the United States. Vaccine. 2017;35(37):5065-5072.