title: Rapid Declines in Age Group-Specific Rotavirus Infection and Acute Gastroenteritis Among Vaccinated and Unvaccinated Individuals Within 1 Year of Rotavirus Vaccine Introduction in England and Wales.
abstract: BACKGROUND
  The oral infant rotavirus vaccine, Rotarix, was introduced in England and Wales in July 2013. We estimated the impact on laboratory-confirmed rotavirus infections and hospitalizations for all-cause acute gastroenteritis (AGE) during the first year after introduction.
  
  
  METHODS
  We extracted data on laboratory-confirmed rotavirus infections (July 2000 through June 2015) and all-cause AGE-associated hospitalizations (July 2007 through June 2014) for all age groups using national databases (LabBase2 and HES). We determined the ratio of the rate during the 2013-2014 rotavirus season to the rate during the prevaccination era.
  
  
  RESULTS
  In infants, there was a 77% decline (rate ratio [RR], 0.23; 95% confidence interval [CI], .16-.32) in laboratory-confirmed rotavirus infections and a 26% decline (RR, 0.74; 95% CI, .65-.84) in all-cause AGE-associated hospitalizations in 2013-2014, compared with the prevaccination era. Large reductions were also observed in older children, adults, and older adults. We estimated that 10 884 laboratory-confirmed infections and 50 427 all-cause AGE-associated hospital admissions were averted in 2013-2014. Similar reductions have been observed for laboratory-confirmed rotavirus infections during the 2014-2015 season.
  
  
  CONCLUSIONS
  The rapid declines in rotavirus infection and AGE in vaccinated and unvaccinated age groups within 1 year of introducing an infant rotavirus vaccination program are far greater than expected and than previously reported by other countries.
authors.affiliation: Immunisation, Hepatitis, and Blood Safety Department Department of Primary Care and Public Health, Imperial College, London, United Kingdom.
authors.forename: Christina J
authors.initials: CJ
authors.lastname: Atchison
authors.affiliation: Immunisation, Hepatitis, and Blood Safety Department.
authors.forename: Julia
authors.initials: J
authors.lastname: Stowe
authors.affiliation: Immunisation, Hepatitis, and Blood Safety Department.
authors.forename: Nick
authors.initials: N
authors.lastname: Andrews
authors.affiliation: Immunisation, Hepatitis, and Blood Safety Department.
authors.forename: Sarah
authors.initials: S
authors.lastname: Collins
authors.affiliation: Virus Reference Department, Centre for Infectious Disease Surveillance and Control, Public Health England.
authors.forename: David J
authors.initials: DJ
authors.lastname: Allen
authors.affiliation: Virus Reference Department, Centre for Infectious Disease Surveillance and Control, Public Health England.
authors.forename: Sameena
authors.initials: S
authors.lastname: Nawaz
authors.affiliation: Virus Reference Department, Centre for Infectious Disease Surveillance and Control, Public Health England.
authors.forename: David
authors.initials: D
authors.lastname: Brown
authors.affiliation: Immunisation, Hepatitis, and Blood Safety Department.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Ramsay
authors.affiliation: Immunisation, Hepatitis, and Blood Safety Department.
authors.forename: Shamez N
authors.initials: SN
authors.lastname: Ladhani
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004739:England / Q000453:epidemiology; D005759:Gastroenteritis / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D012400:Rotavirus Infections / Q000453:epidemiology / Q000517:prevention & control*; D022243:Rotavirus Vaccines / Q000276:immunology*; D013997:Time Factors; D014852:Wales / Q000453:epidemiology; D055815:Young Adult
chemical_list: D022243:Rotavirus Vaccines
keywords: diarrhea; gastroenteritis; immunization; rotavirus; vaccination