Indirect Benefits of Rotavirus Vaccination

After introducing rotavirus vaccine, countries in all regions of the world and at different income levels have observed significant reductions in both rotavirus diarrhea and overall diarrhea hospitalizations. 

 

Reductions in Rotavirus Diarrhea Hospital Admissions

Hospital-based studies in five African and two Eastern European countries showed that two years following the introduction of rotavirus vaccines into their national immunization programs, hospitalizations due to rotavirus had fallen in infants under 12 months of age.(1-8)

Reductions in Overall Diarrhea Hospital Admissions

Data from several countries in different regions of the world demonstrate the large effect that rotavirus vaccine introduction can have on diarrheal hospitalizations. A review of the impact of rotavirus vaccination in 25 countries also found that the decline in hospitalizations from all-cause diarrhea among children post-vaccine introduction did not differ that much across countries with differing child mortality levels.(17)

Reductions in Childhood Diarrheal Deaths

In several middle-income, medium-mortality countries in Latin America, rotavirus vaccine reduced diarrheal deaths in children by half or more.  A review of data from 14 countries found that, on average, the reduction in diarrheal deaths in children following rotavirus vaccine introduction was greater (45–55%) in countries with medium child mortality rates (generally middle-income countries) than in high-mortality, low-income countries (where it was 30–36%).(17)

References

1. Leshem, E., et al., Rotavirus vaccines and health care utilization for diarrhea in the United States (2007–2011). Pediatrics, 2014. 134(1): p. 15–23 

 2. Gheorghita, S., et al., Impact of Rotavirus Vaccine Introduction and Vaccine Effectiveness in the Republic of Moldova. Clinical Infectious Diseases, 2016. 62(Suppl 2): p. S140-S146. 

 3. Armah, G., et al., Impact and Effectiveness of Monovalent Rotavirus Vaccine Against Severe Rotavirus Diarrhea in Ghana. Clinical Infectious Diseases, 2016. 62(suppl 2): p. S200–S207. 

 4. Sahakyan, G., et al., Impact and Effectiveness of Monovalent Rotavirus Vaccine in Armenian Children. Clinical Infectious Diseases, 2016.  

 5. Msimang, V.M., et al., Impact of rotavirus vaccine on childhood diarrheal hospitalization after introduction into the South African public immunization program. Pediatr Infect Dis J, 2013. 32(12): p. 1359–1364.  

 6. de Deus, N., et al., Early impact of rotavirus vaccination in children less than five years of age in Mozambique. Vaccine, 2017.  

 7. Bonkoungou, I.J.O., et al., Impact and effectiveness of pentavalent rotavirus vaccine in children. Vaccine, 2017.  

 8. Wandera, E.A., et al., Impact of rotavirus vaccination on rotavirus and all-cause gastroenteritis in peri-urban Kenyan children. Vaccine, 2017. 35(38): p. 5217–5223 

9. Bonkoungou, I.J.O., et al., Impact and effectiveness of pentavalent rotavirus vaccine in children. Vaccine, 2017. 

10. Armah, G., et al., Impact and Effectiveness of Monovalent Rotavirus Vaccine Against Severe Rotavirus Diarrhea in Ghana. Clinical Infectious Diseases, 2016. 62(suppl 2): p. S200–S207. 

11. Wandera, E.A., et al., Impact of rotavirus vaccination on rotavirus and all-cause gastroenteritis in peri-urban Kenyan children. Vaccine, 2017. 35(38): p. 5217–5223. 

12. de Deus, N., et al., Early impact of rotavirus vaccination in children less than five years of age in Mozambique. Vaccine, 2017. 

13. Msimang, V.M., et al., Impact of rotavirus vaccine on childhood diarrheal hospitalization after introduction into the South African public immunization program. Pediatr Infect Dis J, 2013. 32(12): p. 1359–1364 

14. Sahakyan, G., et al., Impact and Effectiveness of Monovalent Rotavirus Vaccine in Armenian Children. Clinical Infectious Diseases, 2016. 

15. Gheorghita, S., et al., Impact of Rotavirus Vaccine Introduction and Vaccine Effectiveness in the Republic of Moldova. Clinical Infectious Diseases, 2016. 62(Suppl 2): p. S140-S146 

16. Cortese, M.M., et al., Effectiveness of monovalent and pentavalent rotavirus vaccine. Pediatrics, 2013. 132(1): p. e25–33  

17. Burnett, E., et al., Global Impact of Rotavirus Vaccination on Childhood Hospitalizations and Mortality from Diarrhea. Journal of Infectious Disease, 2017. 215(11): p. 1666–1672. 

18. Ngabo, F., et al., Effect of pentavalent rotavirus vaccine introduction on hospital admissions for diarrhoea and rotavirus in children in Rwanda: a time-series analysis. The Lancet Global Health, 2016. 4(2): p. e129–e136 

19. Groome, M.J., et al., Temporal Association of Rotavirus Vaccine Introduction and Reduction in All-Cause Childhood Diarrheal Hospitalizations in South Africa. Clinical Infectious Diseases, 2016. 62(suppl 2): p. S188–S195. 

20. Mpabalwani, E.M., et al., Impact of Rotavirus Vaccination on Diarrheal Hospitalizations in Children Aged <5 Years in Lusaka, Zambia. Clinical Infectious Diseases, 2016. 62(suppl 2): p. S183–S187 

21. Esparza-Aguilar, M., et al., Diarrhoea-related hospitalizations in children before and after implementation of monovalent rotavirus vaccination in Mexico. Bulletin of the World Health Organization, 2014. 92(2): p. 117–125 

22. Costa, I., et al., Sustained decrease in gastroenteritis-related deaths and hospitalizations in children less than 5 years of age after the introduction of rotavirus vaccination a time-trend analysis in Brazil (2001–2010). Pediatric Infectious Disease Journal, 2016. 35(6): p. e180-e190. 

23. Molto, Y., et al., Reduction of diarrhea associated hospitalizations among children aged <5 Years in Panama following the introduction of rotavirus vaccine. Pediatr Infect Dis J, 2011. 30(1 Suppl): p. S16–20. 

24. Leshem, E., et al., Rotavirus vaccines and health care utilization for diarrhea in the United States (2007–2011). Pediatrics, 2014. 134(1): p. 15–23. 

Sources
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The ROTA Council was created in collaboration with an advisory group of 24 child health leaders from around the world. We promote the use of rotavirus vaccines as part of a comprehensive approach to addressing diarrheal disease.

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