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Abstract

The United Kingdom (UK) added rotavirus (RV) vaccine (Rotarix GlaxoSmithKline) to the national vaccine schedule in July 2013. During the 2012–2014 rotavirus seasons, children presenting to the Bristol Royal Hospital for Children Emergency Department with gastroenteritis symptoms had stool virology analysis (real-time PCR) and clinical outcome recorded. Nosocomial cases were identified as patients with non-gastroenteritis diagnosis testing positive for rotavirus > 48h after admission. In comparison to average pre-vaccine seasons, in the first year after vaccine introduction there were 48% fewer attendances diagnosed with gastroenteritis, 53% reduction in gastroenteritis admissions and a total saving of 330 bed-days occupancy. There was an overall reduction in number of rotavirus-positive stool samples with 94% reduction in children aged under one year and a 65% reduction in those too old to have been vaccinated. In the first year after the introduction of universal vaccination against rotavirus we observed a profound reduction in gastroenteritis presentations and admissions with a substantial possible herd effect seen in older children. Extrapolating these findings to the UK population we estimate secondary healthcare savings in the first year of ca £7.5 (€10.5) million. Ongoing surveillance will be required to determine the long-term impact of the RV immunisation programme.

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2015-12-03
2020-02-25
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2015.20.48.30077
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References

  1. Tate JE, Burton AH, Boschi-Pinto C, Steele AD, Duque J, Parashar UDWHO-coordinated Global Rotavirus Surveillance Network. 2008 estimate of worldwide rotavirus-associated mortality in children younger than 5 years before the introduction of universal rotavirus vaccination programmes: a systematic review and meta-analysis. Lancet Infect Dis. 2012;12(2):136-41. . https://doi.org/10.1016/S1473-3099(11)70253-5  PMID: 22030330 
  2. Atchison CJ, Tam CC, Hajat S, van Pelt W, Cowden JM, Lopman BA. Temperature-dependent transmission of rotavirus in Great Britain and The Netherlands. Proc R Soc B Biol Sci. 2010 Mar 22;277(1683):933-42.
  3. Marlow RD, Finn A. The promise of immunisation against rotavirus. Arch Dis Child. 2012;97(8):736-40. . https://doi.org/10.1136/archdischild-2011-301472  PMID: 22611059 
  4. World Health Organization (WHO). Weekly Epidemiological Record (WER). 18 December 2009, vol. 84, 50 (pp 533-540). Geneva: WHO; 2009. [Accessed 25 Oct 2010]. Available from: http://www.who.int/wer/2009/wer8451_52/en/index.html
  5. World Health Organization (WHO). WHO immunization schedule information. Geneva: WHO. [Accessed 15 Sep 2014]. Available from: http://apps.who.int/immunization_monitoring/globalsummary/schedules
  6. Jit M, Edmunds WJ. Evaluating rotavirus vaccination in England and Wales. Part II. The potential cost-effectiveness of vaccination. Vaccine. 2007;25(20):3971-9. . https://doi.org/10.1016/j.vaccine.2007.02.070  PMID: 17400341 
  7. Lorgelly PK, Joshi D, Iturriza Gómara M, Gray J, Mugford M. Exploring the cost effectiveness of an immunization programme for rotavirus gastroenteritis in the United Kingdom. Epidemiol Infect. 2008;136(1):44-55. . https://doi.org/10.1017/S0950268807008151  PMID: 17335631 
  8. Department of Health. National immunisation programme: planned changes for 2013 to 2014. London: Department of Health. [Accessed 27 Oct 2014]. Available from: https://www.gov.uk/government/publications/national-immunisation-programme-planned-changes-for-2013-to-2014
  9. News BBC. Babies to get ‘gut bug vaccine’. BBC [Internet]. 10 Nov 2012. Available from: http://www.bbc.co.uk/news/health-20268350
  10. Ruuska T, Vesikari T. Rotavirus disease in Finnish children: use of numerical scores for clinical severity of diarrhoeal episodes. Scand J Infect Dis. 1990;22(3):259-67. . https://doi.org/10.3109/00365549009027046  PMID: 2371542 
  11. Department of Health. NHS reference costs 2012 to 2013. London: Department of Health. [Accessed 29 Oct 2014]. Available from: https://www.gov.uk/government/publications/nhs-reference-costs-2012-to-2013
  12. R Core Team. R: A Language and Environment for Statistical Computing [Internet]. Vienna, Austria: R Foundation for Statistical Computing; 2014. Available from: http://www.R-project.org/
  13. Office for National Statistics. Population Estimates for England and Wales Mid-2012. London: Office for National Statistics. [Accessed 27 Oct 2014]. Available from: http://www.ons.gov.uk/ons/rel/pop-estimate/population-estimates-for-england-and-wales/mid-2012/index.html
  14. Feikin DR, Scott JAG, Gessner BD. Use of vaccines as probes to define disease burden. Lancet. 2014;383(9930):1762-70. . https://doi.org/10.1016/S0140-6736(13)61682-7  PMID: 24553294 
  15. Rodrigues F, Iturriza-Gómara M, Marlow R, Gray J, Nawaz S, Januário L, et al. The evolving epidemiology of rotavirus gastroenteritis in central Portugal with modest vaccine coverage. J Clin Virol. 2013;56(2):129-34. . https://doi.org/10.1016/j.jcv.2012.10.016  PMID: 23238239 
  16. Sáfadi MAP, Berezin EN, Munford V, Almeida FJ, de Moraes JC, Pinheiro CF, et al. Hospital-based surveillance to evaluate the impact of rotavirus vaccination in São Paulo, Brazil. Pediatr Infect Dis J. 2010;29(11):1019-22. PMID: 20543761 
  17. Räsänen S, Lappalainen S, Salminen M, Huhti L, Vesikari T. Noroviruses in children seen in a hospital for acute gastroenteritis in Finland. Eur J Pediatr. 2011;170(11):1413-8. . https://doi.org/10.1007/s00431-011-1443-4  PMID: 21465124 
  18. Hahné S, Hooiveld M, Vennema H, van Ginkel A, de Melker H, Wallinga J, et al. Exceptionally low rotavirus incidence in the Netherlands in 2013/14 in the absence of rotavirus vaccination. Euro Surveill. 2014;19(43):20945. . https://doi.org/10.2807/1560-7917.ES2014.19.43.20945  PMID: 25375899 
  19. Braeckman T, Van Herck K, Meyer N, Pirçon J-Y, Soriano-Gabarró M, Heylen E, et al. RotaBel Study Group. Effectiveness of rotavirus vaccination in prevention of hospital admissions for rotavirus gastroenteritis among young children in Belgium: case-control study. BMJ. 2012;345(aug08 1):e4752. . https://doi.org/10.1136/bmj.e4752  PMID: 22875947 
  20. Marlow R, Ferreira M, Cordeiro E, Trotter C, Januário L, Finn A, et al. Case control study of rotavirus vaccine effectiveness in Portugal during 6 years of private market use. Pediatr Infect Dis J. 2015 May;34(5):509-12;34(5):509-12.
  21. Buttery JP, Lambert SB, Grimwood K, Nissen MD, Field EJ, Macartney KK, et al. Reduction in rotavirus-associated acute gastroenteritis following introduction of rotavirus vaccine into Australia’s National Childhood vaccine schedule. Pediatr Infect Dis J. 2011;30(1) Suppl;S25-9. . https://doi.org/10.1097/INF.0b013e3181fefdee  PMID: 21183837 
  22. Atkins KE, Shim E, Pitzer VE, Galvani AP. Impact of rotavirus vaccination on epidemiological dynamics in England and Wales. Vaccine. 2012;30(3):552-64. . https://doi.org/10.1016/j.vaccine.2011.11.064  PMID: 22133508 
  23. Atchison C, Lopman B, Edmunds WJ. Modelling the seasonality of rotavirus disease and the impact of vaccination in England and Wales. Vaccine. 2010;28(18):3118-26. . https://doi.org/10.1016/j.vaccine.2010.02.060  PMID: 20197142 
  24. Rijksinstituut voor Volksgezondheid en Milieu (RIVM). Infectieziekten Bulletin. 2015;26(2):54. Bilthoven: RIVM. Dutch. Available from: http://www.rivm.nl/dsresource?objectid=rivmp:272637&type=org&disposition=inline
  25. Tate JE, Cortese MM, Payne DC, Curns AT, Yen C, Esposito DH, et al. Uptake, impact, and effectiveness of rotavirus vaccination in the United States: review of the first 3 years of postlicensure data. Pediatr Infect Dis J. 2011;30(1) Suppl;S56-60. . https://doi.org/10.1097/INF.0b013e3181fefdc0  PMID: 21183842 
  26. Tate JE, Haynes A, Payne DC, Cortese MM, Lopman BA, Patel MM, et al. Trends in national rotavirus activity before and after introduction of rotavirus vaccine into the national immunization program in the United States, 2000 to 2012. Pediatr Infect Dis J. 2013;32(7):741-4. . https://doi.org/10.1097/INF.0b013e31828d639c  PMID: 23426425 
  27. Elam-Evans LD, Yankey D, Singleton JA, Kolasa MCenters for Disease Control and Prevention (CDC). National, state, and selected local area vaccination coverage among children aged 19-35 months - United States, 2013. MMWR Morb Mortal Wkly Rep. 2014;63(34):741-8. PMID: 25166924 
  28. Zeller M, Rahman M, Heylen E, De Coster S, De Vos S, Arijs I, et al. Rotavirus incidence and genotype distribution before and after national rotavirus vaccine introduction in Belgium. Vaccine. 2010;28(47):7507-13. . https://doi.org/10.1016/j.vaccine.2010.09.004  PMID: 20851085 
  29. Public Health England (PHE). National rotavirus immunisation programme: preliminary data for England, October 2013 to September 2014. Health Protection Report. 2014 Oct 24;8(41). Available from: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/367155/hpr4114_rotavirus_v4.pdf
  30. Snelling TL, Andrews RM, Kirkwood CD, Culvenor S, Carapetis JR. Case-control evaluation of the effectiveness of the G1P[8] human rotavirus vaccine during an outbreak of rotavirus G2P[4] infection in central Australia. Clin Infect Dis. 2011;52(2):191-9. . https://doi.org/10.1093/cid/ciq101  PMID: 21288843 
  31. Justino MCA, Linhares AC, Lanzieri TM, Miranda Y, Mascarenhas JDP, Abreu E, et al. Effectiveness of the monovalent G1P[8] human rotavirus vaccine against hospitalization for severe G2P[4] rotavirus gastroenteritis in Belém, Brazil. Pediatr Infect Dis J. 2011;30(5):396-401. . https://doi.org/10.1097/INF.0b013e3182055cc2  PMID: 21150692 
  32. Gurgel RQ, Alvarez AJ, Rodrigues A, Ribeiro RR, Dolabella SS, Da Mota NL, et al. Incidence of rotavirus and circulating genotypes in Northeast Brazil during 7 years of national rotavirus vaccination. PLoS ONE. 2014;9(10):e110217. . https://doi.org/10.1371/journal.pone.0110217  PMID: 25360784 
  33. Harris JP, Jit M, Cooper D, Edmunds WJ. Evaluating rotavirus vaccination in England and Wales. Part I. Estimating the burden of disease. Vaccine. 2007;25(20):3962-70. . https://doi.org/10.1016/j.vaccine.2007.02.072  PMID: 17395343 
Assessing the impacts of the first year of rotavirus vaccination in the United Kingdom
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Robin+Marlow&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Marlow Robin</a>, <a href="/search?value1=Peter+Muir&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Muir Peter</a>, <a href="/search?value1=Barry+Vipond&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Vipond Barry</a>, <a href="/search?value1=Mark+Lyttle&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lyttle Mark</a>, <a href="/search?value1=Caroline+Trotter&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Trotter Caroline</a>, <a href="/search?value1=Adam+Finn&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Finn Adam</a></span>. Assessing the impacts of the first year of rotavirus vaccination in the United Kingdom. <a href="/content/ecdc">Euro Surveill.</a> 2015;20(48):pii=30077. <a href="https://doi.org/10.2807/1560-7917.ES.2015.20.48.30077" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2015.20.48.30077</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 25 Nov 2014;&nbsp;&nbsp; <span class="generated">Accepted</span>: 27 Apr 2015 </span> </p>
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