Cocontribution of Rotavirus and Pneumococcal Conjugate Vaccines to the Reduction of Pediatric Hospital Visits in Young Children

• Published in: The Journal of pediatrics Vol. 182; pp. 253 - 259.e2
• Main Authors: Ben-Shimol, Shalom, MD, Givon-Lavi, Noga, PhD, Greenberg, David, MD, Dagan, Ron, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2017
• Subjects: Age Factors; Child, Preschool; Cohort Studies; Confidence Intervals; Emergency Service, Hospital - utilization; Female; health care service utilization; Hospitals, Pediatric - utilization; Humans; immunization; Incidence; Infant; infectious disease burden; Israel - epidemiology; Male; Odds Ratio; Outcome Assessment (Health Care); Pediatrics; Pneumococcal Infections - epidemiology; Pneumococcal Infections - prevention & control; Pneumococcal Vaccines - administration & dosage; Prospective Studies; Risk Assessment; Rotavirus Infections - epidemiology; Rotavirus Infections - prevention & control; Rotavirus Vaccines - administration & dosage; Sex Distribution; Sex Factors; Vaccination; Pneumococcal conjugate vaccine; LRI; PCV; PCV13; 7-valent pneumococcal conjugate vaccine; RVGE; health care service utilization; National Immunization Plan; Rotavirus gastroenteritis; 13-valent pneumococcal conjugate vaccine; PCV7; RVV; NIP; immunization; infectious disease burden; Rotavirus vaccine; Lower respiratory tract infection; SUMC; Soroka University Medical Center
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2016.11.041

Objective To assess rotavirus vaccine and pneumococcal conjugate vaccines (PCVs) cumulative impact on the pediatric emergency department visits and hospitalization rates in children <2 years of age in southern Israel between April 2006 and March 2014. Study design This prospective, population-based observational study calculated the rates of rotavirus gastroenteritis (RVGE), non-RVGE, community-acquired alveolar pneumonia (CAAP), nonalveolar lower respiratory tract infection, and all-cause hospital visits. PCV7, PCV13, and rotavirus vaccination programs were implemented in Israel in July 2009, November 2010, and January 2011, respectively. Results From 2006-2009 to 2013-2014, the rates of hospitilizations for RVGE, non-RVGE, CAAP, and nonalveolar lower respiratory tract infection decreased by 78%, 21%, 46%, and 7%, respectively. In outpatients, the respective decreases were 80%, 16%, 67%, and 14%. All-cause outpatient pediatric emergency department visits and hospitalization rates were reduced by 12% and 11%, respectively. During the peak season (October through March), RVGE, non-RVGE, CAAP, and nonalveolar lower respiratory tract infection hospitalization rates decreased significantly by 86%, 44.6%, 23.3%, and 10.5%, respectively. In outpatients, the respective decreases were 81.7%, 73.5%, 13.8%, and 10.7%. The proportion of RVGE and CAAP (grouped) of all-cause hospitalizations and outpatient pediatric ED visits decreased from 19.9% to 12.3% and from 6.9% to 1.8%, respectively. Conclusions Rotavirus vaccine and PCV introduction cocontributed to a rapid, considerable reduction in hospital burden in children <2 years of age. Because seasonalities of both diseases overlap, this reduction is particularly helpful in relieving burdens of disease and care during the most cumbersome morbidity season.