Rotavirus vaccination helps reduce acute gastroenteritis in primary care
The rates of acute gastroenteritis have reduced in primary care in the UK following the introduction of oral rotavirus vaccination in infants, a recent study found.
Two years after rotavirus vaccine introduction, acute gastroenteritis incidence in primary care reduced by 15 percent in infants (target vaccination population aged <1 year; adjusted incidence rate ratio [adjIRR], 0.85, 95 percent confidence interval [CI], 0.76–0.95) compared with the prevaccination period. The decrease in incidence was even more evident during months which historically have a high circulation of rotavirus (adjIRR, 0.59, 95 percent CI, 0.53–0.66). [Vaccine 2016;doi:10.1016/j.vaccine.2016.11.057]
“There was complete loss of the seasonal peak in the months of historically high rotavirus circulation,” said the researchers.
Overall rates of acute gastroenteritis also reduced in children aged 1 year (adjIRR, 0.79, 95 percent CI, 0.69–0.90) and 2, 3, and 4 years (adjIRR, 0.89, 0.89, and 0.87, respectively).
There were less evident decreases in primary care acute gastroenteritis rates in older children (adjIRR, 0.92 in children aged 5–14 years) and adults (adjIRR, 0.95, 0.91, and 0.94 in individuals aged 15–44, 45–64, and ≥65 years, respectively), though there appeared to be a decrease of 12–16 percent during the high rotavirus season.
The reductions in acute gastroenteritis among children who were ineligible for rotavirus vaccination and older individuals suggest the possibility of herd immunity, said the researchers.
The monovalent live-attenuated oral rotavirus vaccine was introduced in the UK in July 2013, with coverage reaching 93 and 88 percent for one and two doses, respectively by the end of the first year. [Rotavirus Infant Immunization Programme 2014/2015: Vaccine Uptake Report, https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/440456/RotavirusGatewayFinalVersion.pdf, accessed 5/1/2017] Previous research showed a drop in the rates of laboratory-confirmed rotavirus infection and acute gastroenteritis-related hospitalizations within 1 year of vaccine introduction. [J Infect Dis 2016;213:243-249]
Using information acquired from the Clinical Practice Research Datalink, researchers compared acute gastroenteritis rates in the first 2 years postvaccination (July 2013–April 2015) with 5 years prevaccination (July 2008–June 2013). A total of 804,141 cases of acute gastroenteritis (excluding noninfectious acute gastroenteritis of specified cause and chronic diarrhoea) were reported in general practice between July 2008 and April 2015, 0.2 percent of which (n=2,087) was determined to be rotavirus-related.
“We have demonstrated substantial decreases in [acute gastroenteritis] in general practice in the first 2 years of the vaccination programme,” concluded the researchers, who advocated for continued monitoring of this condition in all healthcare settings in the UK.