title: Rotavirus vaccines and health care utilization for diarrhea in the United States (2007-2011).
abstract: OBJECTIVE
  To examine reductions in diarrhea-associated health care utilization after rotavirus vaccine implementation and to assess direct and indirect effectiveness of vaccination.
  
  
  METHODS
  Retrospective cohort analysis of claims data of commercially insured US children aged <5 years. We examined annual pentavalent (RV5) and monovalent (RV1) rotavirus vaccine coverage. We compared rates of diarrhea-associated health care utilization in prevaccine (2001-2006) versus postvaccine introduction (2007-2011) years, compared rates of diarrhea-associated health care utilization in vaccinated versus unvaccinated children and compared rates in unvaccinated children in postvaccine versus prevaccine years.
  
  
  RESULTS
  Among children aged <5 years, RV5 and RV1 rotavirus vaccine coverage rates reached 58% and 5%, respectively, by December 31, 2010. Compared with the average rate of rotavirus-coded hospitalizations in 2001-2006, rates were reduced by 75% in 2007-2008, 60% in 2008-2009, 94% in 2009-2010, and 80% in 2010-2011. Compared with unvaccinated children, in 2010-2011, the rate of rotavirus-coded hospitalizations was reduced by 92% among RV5 recipients and 96% among RV1 recipients. Rotavirus-coded hospitalization rate reductions among RV5 recipients versus unvaccinated children ranged from 87% among <1-year-olds to 81% among 4-year-olds. Compared with prevaccine rates in 2001-2006, rotavirus-coded hospitalization rates among unvaccinated children decreased by 50% in 2007-2008, 77% in 2009-2010, and 25% in 2010-2011.
  
  
  CONCLUSIONS
  Implementation of rotavirus vaccines has substantially reduced diarrhea health care utilization in US children. Both rotavirus vaccines conferred high protection against rotavirus hospitalizations; RV5 conferred durable protection through the fourth year of life. Vaccination also conferred indirect benefits to unvaccinated children.
authors.affiliation: National Center for Immunization and Respiratory Diseases, andEpidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia eleshem@cdc.gov.
authors.forename: Eyal
authors.initials: E
authors.lastname: Leshem
authors.affiliation: National Center for Immunization and Respiratory Diseases, and.
authors.forename: Rebecca E
authors.initials: RE
authors.lastname: Moritz
authors.affiliation: National Center for Immunization and Respiratory Diseases, and.
authors.forename: Aaron T
authors.initials: AT
authors.lastname: Curns
authors.affiliation: National Center for Immunization and Respiratory Diseases, and.
authors.forename: Fangjun
authors.initials: F
authors.lastname: Zhou
authors.affiliation: National Center for Immunization and Respiratory Diseases, and.
authors.forename: Jacqueline E
authors.initials: JE
authors.lastname: Tate
authors.affiliation: National Center for Immunization and Respiratory Diseases, and.
authors.forename: Benjamin A
authors.initials: BA
authors.lastname: Lopman
authors.affiliation: National Center for Immunization and Respiratory Diseases, and.
authors.forename: Umesh D
authors.initials: UD
authors.lastname: Parashar
mesh_terms: D002662:Child Health Services / Q000706:statistics & numerical data*; D002675:Child, Preschool; D015331:Cohort Studies; D003967:Diarrhea / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D007223:Infant; D012189:Retrospective Studies; D022243:Rotavirus Vaccines; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D022243:Rotavirus Vaccines
keywords: United States; diarrhea; hospitalization; rotavirus; rotavirus vaccines