Reduction in Gastroenteritis With the Use of Pentavalent Rotavirus Vaccine in a Primary Practice
I have previously looked at studies that looked at acute gastroenteritis (AGE) rates of hospitalizations before and after the introduction of the pentavalent rotavirus vaccine (RV5). Those studies noted a significant reduction in AGE hospitalization rates following the introduction of the RV5 in 2006. In this entry, I will summarize yet another study along the same lines.
AGE, commonly referred to as the “stomach flu“, is a viral infection, and rotavirus is the leading cause of severe gastroenteritis in children, credited with causing about 50% of acute gastroenteritis hospitalizations during January-June among U.S. children. Logically, if rotavirus causes it, and if an effective vaccine is introduced, we ought to observe statistically significant decreases in gastroenteritis hospitalization rates, and this is what this analysis was set up to do.
The study we will look at today, was published in the journal Pediatrics and the abstract can be accessed by clicking the link below.
Rodolfo E. Bégué, MDa, Keith Perrin, MDb
Study Summary – The authors followed up children under 5 years of age, who presented with AGE in a large pediatrics practice in New Orleans, between 2004 and 2009. Primary care physician office visits, emergency department visits, and hospital admissions were identified by review of records. RV testing was performed only on those who were seen at the hospital. Overall, about 16,000 children were included in this study.
Results – For 2006–2007, 2007–2008, and 2008–2009, 11.1%, 40.3%, and 45.6% of age-eligible children, respectively, received 1 dose of RV5. As compared with 2004–2005 (before RV5), in 2007–2009, there was a significant decrease in all-cause AGE office visits (23%) and hospitalizations (50%). RV-positive cases (emergency department visits or hospitalizations) decreased by 67%. The decrease in RV-positive cases was more evident among children who were younger than 2 years (81%), with a strong trend among those who were aged 2 to <5 years (41%).
Conclusion – This study adds more evidence that the introduction of the pentavalent rotavirus vaccine led to a significant decrease in all-cause AGE hospitalizations, and especially rotavirus-caused AGE. Taken together with the previous 3 studies we’ve reviewed, the evidence seems very solid and is strongly suggestive of a correlation between the introduction of RV5 in 2006, and significant decreases in AGE hospitalizations. The authors of the above study concluded as such:
Increased use of RV5 in a pediatric practice was associated with fewer AGE office visits and hospitalizations. The reduction was specific for RV-positive AGE and seen among children who were targeted for immunization as well as older groups, suggesting a herd-immunity effect.