title: Change in incidence of clinic visits for all-cause and rotavirus gastroenteritis in young children following the introduction of universal rotavirus vaccination in Israel.
abstract: Both rotavirus vaccines RotaTeq and Rotarix were efficacious against severe rotavirus gastroenteritis in clinical trials; yet real-world data on the effect of rotavirus vaccines on mild to moderate disease are limited. We used a large computerised database of Maccabi Health Services Health Maintenance Organisation (HMO), the second largest HMO in Israel covering 25% of the Israeli population, to compare the incidence of acute gastroenteritis (AGE) clinic visits in community settings (n=302,445) before (2005-10) and after (2011-13) the introduction of universal rotavirus immunisation in Israel. We retrieved laboratory results of rotavirus antigen tests (n=18,133) and using a weighted analysis, we estimated the impact of rotavirus immunisation on the disease burden of rotavirus AGE clinic visits. Following the introduction of universal rotavirus immunisation, the typical winter peaks of rotavirus AGE were substantially lower and significant reductions of 14.8% (95% confidence interval (CI): 13.5-16.1) in all-cause AGE clinic visits and of 59.7% (95% CI: 59.8-62.6) in rotavirus AGE clinic visits were observed. The decrease was observed in all age groups, but it was greater in children aged 0 to 23 months than those aged 24 to 59 months. Continued rotavirus laboratory surveillance is warranted to monitor the sustainability of these changes.
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Khitam
authors.initials: K
authors.lastname: Muhsen
authors.forename: Gabriel
authors.initials: G
authors.lastname: Chodick
authors.forename: Sophy
authors.initials: S
authors.lastname: Goren
authors.forename: Emilia
authors.initials: E
authors.lastname: Anis
authors.forename: Tomer
authors.initials: T
authors.lastname: Ziv-Baran
authors.forename: Varda
authors.initials: V
authors.lastname: Shalev
authors.forename: Dani
authors.initials: D
authors.lastname: Cohen
mesh_terms: D000914:Antibodies, Viral / Q000097:blood; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D006801:Humans; D017589:Immunization Programs / Q000458:organization & administration*; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies; D012401:Rotavirus / Q000276:immunology*; D012400:Rotavirus Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000821:virology; D022243:Rotavirus Vaccines / Q000008:administration & dosage* / Q000009:adverse effects / Q000276:immunology; D016896:Treatment Outcome; D014613:Vaccines, Attenuated
chemical_list: D000914:Antibodies, Viral; C492457:RIX4414 vaccine; C492535:RotaTeq; D022243:Rotavirus Vaccines; D014613:Vaccines, Attenuated
keywords: acute gastroenteritis; children; clinic visits; rotavirus; rotavirus vaccination; vaccine impact