title: Impact of a publicly funded monovalent rotavirus vaccination program in the Province of Quebec (Canada).
abstract: In November 2011, the province of Quebec, Canada implemented a publicly funded rotavirus (RV) vaccination program using the monovalent RV vaccine (RV1). To assess its impact, trends in passive RV laboratory detection and Emergency Department (ED) visits for gastroenteritis (GE) at two pediatric centers were evaluated.
  
  
  METHODS
  RV tests performed were extracted from the virology laboratory databases and ED visits for GE between July 1, 2006 and June 30, 2013, from the ED databases of The Montreal Children's Hospital (MCH) and Centre Hospitalier Universitaire de Sherbrooke (CHUS). The percent positive RV tests over time and season duration were assessed using 5-week moving averages. We defined season start and end as the first two and the last two consecutive weeks where the percent positive RV tests were ≥ 10%, respectively.
  
  
  RESULTS
  Comparing the pre- and post-vaccination program periods, a decrease in the proportion of positive RV tests was seen: 15.9% vs. 5.1% (p<0.001). Pre-vaccination program, RV seasons started between December and February, peaked in March or April and ended in May. In 2011-2012, the season started in March, peaked in April, and ended in May. In 2012-2013, the season lasted 3 weeks in May. ED visits for GE decreased post-introduction of the RV1 program: from 4.8% to 3.4% in 2011-2012, and 4.2% in 2012-13 (p<0.001). In children <2 years of age, ED GE visits decreased from 7.5% to 4.8% in 2011-2012, and 5.2% in 2012-2013 (p<0.001). Admissions for GE also decreased significantly from 0.41% of all ED visits to 0.14% in 2011-2012 and 0.22% in 2012-2013 (p<0.005).
  
  
  CONCLUSIONS
  Implementation of a publicly funded RV vaccination program had a major impact on the epidemiology of RV infections in Quebec: RV seasons have started later and been of shorter duration, peak positives were fewer, and ED visits for GE decreased.
authors.affiliation: Division of Infectious Diseases, Department of Pediatrics and Department of Medical Microbiology, The Montreal Children's Hospital, McGill University, E05-1954 - 1001 Decarie Blvd, Montreal (QC) H4A 3J1, Canada. Electronic address: jeannette.comeau@mail.mcgill.ca.
authors.forename: Jeannette L
authors.initials: JL
authors.lastname: Comeau
authors.affiliation: Department of Pediatrics, Université de Sherbrooke, 3001 12e Avenue Nord, Sherbrooke (QC) J1H 5N4, Canada. Electronic address: arnaud.gagneur@usherbrooke.ca.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Gagneur
authors.affiliation: Division of Infectious Diseases, Department of Pediatrics and Department of Medical Microbiology, The Montreal Children's Hospital, McGill University, E05-1954 - 1001 Decarie Blvd, Montreal (QC) H4A 3J1, Canada; Division des risques biologiques et de la santé au travail - Institut national de santé publique du Québec, 190 Crémazie Blvd E., Montreal (QC) H2P 1E2, Canada; Department of Epidemiology, Biostatistics, and Occupational Health - McGill University, 1020 Pine Avenue W, Montreal (QC) H3A 1A2, Canada; MUHC Vaccine Study Centre, 14770 Pierrefonds Blvd, Suite 204, Montreal (QC) H9H 4Y6, Canada. Electronic address: caroline.quach@mcgill.ca.
authors.forename: Caroline
authors.initials: C
authors.lastname: Quach
mesh_terms: D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005759:Gastroenteritis / Q000453:epidemiology / Q000517:prevention & control*; D006784:Hospitals, Teaching; D006801:Humans; D017589:Immunization Programs; D007223:Infant; D011159:Population Surveillance; D011792:Quebec; D012401:Rotavirus; D012400:Rotavirus Infections / Q000453:epidemiology / Q000517:prevention & control*; D022243:Rotavirus Vaccines / Q000627:therapeutic use*; D062606:Tertiary Care Centers
chemical_list: D022243:Rotavirus Vaccines
keywords: Epidemiology; Gastroenteritis; Pediatrics; Rotavirus; Vaccination