title: Effect of rotavirus vaccine on reducing acute gastroenteritis in a large outpatient pediatric network.
abstract: OBJECTIVE
  To measure the effect of rotavirus vaccine (RVV) on acute gastroenteritis (AGE) managed by primary care physicians in the first 2 rotatvirus seasons following the introduction of RVV.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Practice-based network composed of 33 ambulatory pediatric practices in Philadelphia, Pennsylvania.
  
  
  METHODS
  All children born from February 22, 2006 (date of RVV licensure), through February 29, 2008, and who received care at any network site.
  
  
  METHODS
  Receipt of RVV.
  
  
  METHODS
  The primary outcomes were AGE-related office visits, telephone calls, and episodes (composite outcome consisting of all visits and calls within a 10-day period).
  
  
  RESULTS
  Rates of AGE visits in the 2 rotavirus seasons following the introduction of RVV steadily decreased from 3.0 AGE visits per 100 total office visits in the 2005 season to 1.8 in the 2008 season. In 2007, vaccinations were administered to 9351 of 13 951 vaccine-eligible children (67.0%), and in 2008, they were administered to 9958 of 10 728 (92.8%). Among RVV-immunized children in 2007, AGE calls and episodes were significantly reduced with vaccine effectiveness of 53% and 46%, respectively. No significant difference was seen between RVV-immunized and RVV-nonimmunized children for any outcome in 2008.
  
  
  CONCLUSIONS
  Rotavirus vaccine was associated with a significant reduction in outpatient AGE calls and episodes among immunized children in our network in 2007. Despite a reduction in winter AGE rates in the network, no difference was detected between RVV-immunized and RVV-nonimmunized children for any outcome in 2008. Further study is needed to understand the lack of vaccine effect in 2008.
authors.affiliation: Division of Infectious Diseases, The Children's Hospital of Philadelphia, 34th St and Civic Center Blvd, Philadelphia, PA 19104, USA. sheilanolan@hotmail.com
authors.forename: Sheila M
authors.initials: SM
authors.lastname: Nolan
authors.forename: Priya
authors.initials: P
authors.lastname: Prasad
authors.forename: Alexander G
authors.initials: AG
authors.lastname: Fiks
authors.forename: Theoklis
authors.initials: T
authors.lastname: Zaoutis
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Tenhave
authors.forename: Susan E
authors.initials: SE
authors.lastname: Coffin
mesh_terms: D000208:Acute Disease; D000553:Ambulatory Care; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies; D022243:Rotavirus Vaccines
chemical_list: D022243:Rotavirus Vaccines