- Khitam Muhsen1,2, Gabriel Chodick1,2,3, Sophy Goren1, Emilia Anis4, Tomer Ziv-Baran1, Varda Shalev1,3, Dani Cohen1
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View Affiliations Hide AffiliationsAffiliations: 1 Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel 2 These authors contributed equally to the article 3 Medical Division, Maccabi Health Services, Tel Aviv, Israel 4 Division of Epidemiology, Ministry of Health, Jerusalem, IsraelKhitam Muhsenkmuhsen post.tau.ac.il
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Citation style for this article: Muhsen Khitam, Chodick Gabriel, Goren Sophy, Anis Emilia, Ziv-Baran Tomer, Shalev Varda, Cohen Dani. Change in incidence of clinic visits for all-cause and rotavirus gastroenteritis in young children following the introduction of universal rotavirus vaccination in Israel. Euro Surveill. 2015;20(42):pii=30045. https://doi.org/10.2807/1560-7917.ES.2015.20.42.30045 Received: 19 Dec 2014; Accepted: 17 Mar 2015
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.

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