title: Impact of high coverage of monovalent human rotavirus vaccine on Emergency Department presentations for rotavirus gastroenteritis.
abstract: BACKGROUND
  Australia was one of the first countries to introduce nationally funded rotavirus vaccination. The program has had a substantial impact on both rotavirus and all-cause acute gastroenteritis (AGE) hospitalisations and rotavirus laboratory tests. Evidence for an impact on Emergency Department (ED) presentations is limited. This study assessed changes in ED presentations for rotavirus in children aged <5 years in New South Wales, Australia, following introduction of monovalent human rotavirus vaccine (RV1, Rotarix(®), GlaxoSmithKline Australia Pty Ltd., Victoria, Australia).
  
  
  METHODS
  A time series analysis to examine trends in total non-admitted ED presentations for all-cause AGE and in the rotavirus-attributable fraction using data on rotavirus positive laboratory tests.
  
  
  RESULTS
  A decline in the rate of non-admitted ED presentations for all-cause AGE was observed for all ages, being most notable in 1 year old children. Compared with the pre-vaccination period, we estimated the average weekly rate was lower across the first 4.5 years of the program for both all-cause AGE (18.3%; 70.5 versus 57.5 per 100,000 population) and rotavirus attributable (55.4%; 17.3 versus 7.7 per 100,000 population) presentations. In the fourth year of the program, estimated annual rotavirus attributable presentations were 77% lower than the pre-vaccination annual mean (996 versus 4300 per year).
  
  
  CONCLUSIONS
  The program was associated with a substantial decline in rotavirus attributable non-admitted AGE presentations to ED among children aged <5 years.
authors: Centre for Epidemiology and Evidence, NSW Ministry of Health, North Sydney, NSW 2060, Australia.
authors: Heather M
authors: HM
authors: Davey
authors: Centre for Epidemiology and Evidence, NSW Ministry of Health, Locked Mail Bag 961, North Sydney, NSW 2059 Australia. Electronic address: dmusc@doh.health.nsw.gov.au.
authors: David J
authors: DJ
authors: Muscatello
authors: School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW 2052, Australia.
authors: James G
authors: JG
authors: Wood
authors: The Telethon Kids Institute, Subiaco, 6008 WA, Australia.
authors: Thomas L
authors: TL
authors: Snelling
authors: School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW 2052, Australia; Public Health Unit, South Eastern Sydney Local Health District, Randwick, NSW 2031, Australia.
authors: Mark J
authors: MJ
authors: Ferson
authors: National Centre for Immunisation Research and Surveillance (NCIRS), Westmead, NSW 2145, Australia; Discipline of Paediatrics and Child Health, University of Sydney, NSW 2006, Australia.
authors: Kristine K
authors: KK
authors: Macartney
mesh_terms: D000293:Adolescent; D001315:Australia / Q000453:epidemiology; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005759:Gastroenteritis / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D007223:Infant; D008297:Male; D012401:Rotavirus / Q000302:isolation & purification; D012400:Rotavirus Infections / Q000453:epidemiology / Q000517:prevention & control*; D022243:Rotavirus Vaccines / Q000008:administration & dosage*; D013997:Time Factors; D014613:Vaccines, Attenuated / Q000008:administration & dosage
chemical_list: C492457:RIX4414 vaccine; D022243:Rotavirus Vaccines; D014613:Vaccines, Attenuated
keywords: Children; Emergency Department; Gastroenteritis; Rotavirus; Vaccination