Rotavirus vaccines for low birth weight (LBW) and very LBW (VLBW) infants were highly effective and substantially reduced acute gastroenteritis hospitalizations, according to research published in the Pediatric Infectious Disease Journal.
Inpatient commercial claim data for US infants younger than 5 years, from July 2001 to June 2015, were used to investigate the numbers of acute gastroenteritis claims and rotavirus-coded hospitalizations. Rate reductions were calculated using prevaccine (2001-2006) and postvaccine (2007-2015) periods.
Rotavirus vaccine coverage, as of 2014, was 87%, 82%, and 64% for normal birth weight (NBW), LBW, and VLBW infants, respectively. In 2014 to 2015, acute gastroenteritis hospitalization rate reductions relative to the prevaccine period were 60% for NBW infants (95% CI, 58%-61%), 64% for LBW infants (95% CI, 57%-70%), and 55% for VLBW infants (95% CI, 39%-67%).
Reduction rates in rotavirus hospitalizations for NBW, LBW, and VLBW infants were 91% (95% CI, 90%-92%), 98% (95% CI, 93%-100%), and 93% (95% CI, 70%-98%), respectively. The vaccines also resulted in 62% (95% CI, 51%-71%), 72% (95% CI, 44%-86%), and 71% (95% CI, 7%-91%) reductions in acute gastroenteritis hospitalization rates comparing vaccinated vs unvaccinated NBW, LBW, and VLBW children aged 3 to 23 months, respectively.
Vaccination coverage is now at the highest levels since the introduction of 2 rotavirus vaccines in 2006 and 2008. However, the VLBW group still has significantly lower coverage rates, possibly as a result of being ineligible to receive the first dose of vaccine if they were older than 14 weeks when discharged from the neonatal intensive care unit. Acute gastroenteritis hospitalizations were also higher in the VLBW compared with LBW patients, but rates declined in both groups by 64% and 55%, respectively, demonstrating the vaccine effectiveness for these high-risk groups.
The study data only included infants with private insurance, and therefore may not be generalizable to all US infants born below NBW, of whom 50% are believed to be receiving Medicaid. Regardless, the authors concluded that the vaccines have dramatically reduced hospitalization rates for LBW and VLBW infants, and efforts to improve coverage in these groups should continue.
Dahl RM, Curns AT, Tate JE, Parashar UD. Effect of rotavirus vaccination on acute diarrheal hospitalizations among low and very low birth weight US infants, 2001-2015 [published online February 3, 2018]. Pediatr Infect Dis J. doi: 10.1097/INF.0000000000001930