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Impact of the introduction of rotavirus vaccination on paediatric hospital admissions, Lothian, Scotland: a retrospective observational study
  1. Ruth Forrest1,
  2. Laura Jones1,
  3. Lorna Willocks2,
  4. Alison Hardie3,
  5. Kate Templeton3
  1. 1Royal Hospital for Sick Children, Edinburgh, UK
  2. 2NHS Lothian, Edinburgh, UK
  3. 3Department of Virology, Royal Infirmary Edinburgh, Edinburgh, UK
  1. Correspondence to Dr Ruth Forrest, Royal Hospital for Sick Children, Sciennes Road, Edinburgh EH9 1LF, UK; ruth.forrest1{at}nhs.net

Abstract

Objective Rotavirus (RV) vaccination was introduced into the UK vaccination schedule in July 2013. This retrospective observational study assessed, in a UK setting, the impact of the vaccination programme on the number of RV gastroenteritis (RVGE) admissions, the complications of RVGE in hospitalised children, and the impact on hospital-acquired RVGE.

Design Over a 3 year period, 1-year before and 2 years after the introduction of the vaccine, children under 13 years of age in Lothian region with RV+ve stool sample by PCR were identified, retrospectively, and admission data (length of stay, complications) and vaccination status analysed. Viral strain (vaccine/wild type) was typed using PCR-based methods in vaccinated children.

Results Vaccination uptake in the first 2 years of the programme was 93–94%. In the 2 years following vaccine introduction, the annual number of confirmed RVGE admissions fell by 84.7% (95% CI 75.4 to 91.0), from 131 to 20, bed days reduced by 91.1% (86.9 to 94.1), from 325 to 29, and suspected hospital-acquired infections reduced by 95.7% (73.5–99.5), from 23 to 1. The reduction in admissions was seen across all age groups despite the vaccination only being administered to infants. Despite the reduction in incidence, complication rates in children admitted with RVGE remained unchanged across the three study years. A frequent incidental finding was RV vaccine strain in the stools of vaccinated children, up to 43 days after last immunisation. There has been no concurrent increase in rate of intussusception in the region.

Conclusions These results provide encouraging initial evidence of the public health benefit, including to the unimmunised population, of the RV vaccination programme in the UK.

  • Epidemiology
  • Immunisation
  • Infectious Diseases
  • Virology
  • rotavirus

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Footnotes

  • Author note Co-author Alison Hardie, sadly died after a short illness during the preparation of this manuscript.

  • Contributors The study was designed by RF, LJ, KT and LW. AH was responsible for viral typing and contributed to the Methods section of the manuscript. RF drafted the manuscript; all other authors contributed revisions and agreed with the final manuscript.

  • Competing interests None declared.

  • Ethics approval The study was approved by the NHS Lothian Quality Improvement Team.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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