A population based study comparing changes in rotavirus burden on the Island of Ireland between a highly vaccinated population and an unvaccinated population |
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| Affiliation: | 1. Public Health Agency, 12-22 Linenhall Street, Belfast, Northern Ireland BT2 8BS, UK;2. Health Protection Surveillance Centre, 25-27 Middle Gardiner Street, Dublin 1 DO1 A4A3, Ireland;1. Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States;2. Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, United States;3. Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States;1. Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel;2. Department of Pediatrics, Hillel Yaffe Medical Center, Hadera, Israel;3. Department of Pediatrics, Laniado Medical Center, Netanya, Israel;4. Department of Pediatrics, Carmel Medical Center, Haifa, Israel;5. Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel;6. Central Virology Laboratory, Ministry of Health, Tel Hashomer, Israel;1. Department of Medical Research, Ministry of Health and Sports, Myanmar;2. Yangon Children’s Hospital, Ministry of Health and Sports, Myanmar;1. Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand;2. Faculty of Pharmacy, Mahidol University, Bangkok, Thailand;3. Phetchabun Provincial Health Office, Phetchabun, Thailand;4. Sukhothai Provincial Health Office, Sukhothai, Thailand;5. Department of Medical Science, Ministry of Public Health, Nonthaburi, Thailand;6. Fogarty International Center, National Institutes of Health, Bethesda, MD, USA;1. Hospital Clínico Universitario de Valladolid, Valladolid, Spain;2. Johns Hopkins University, Baltimore, MD, United States;3. Centro de Salud Pilarica, Valladolid, Spain;1. Department of Preventive Medicine & Public Health, Medical Immunology and Microbiology, Rey Juan Carlos University, Madrid, Spain;2. Medical and Scientific Department, Sanofi Pasteur, Madrid, Spain |
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| Abstract: | BackgroundRotavirus infection is a leading cause of gastroenteritis in infants and children globally. Reductions in rotavirus activity have been observed following introduction of rotavirus vaccination programmes, however a reductions have also been reported in some unvaccinated countries.The Island of Ireland incorporates the two jurisdictions Northern Ireland (NI) and the Republic of Ireland (IE). Both have similarities in climate, demography, morbidity and mortality but distinct health administrations and vaccination policies. Rotarix was added to the childhood immunisation programme in NI on the 1 July 2013. IE have not introduced routine rotavirus vaccination to date.The aim of this population based ecological study was to evaluate the impact of the rotavirus vaccine on burden of rotavirus disease in NI, and to compare with IE as an unvaccinated control population. This will help determine if the changes seen were due to the rotavirus vaccine, or due to confounding factors.MethodsA number of population based measures of disease burden were compared in both jurisdictions pre-vaccine (six years; 2007/08–2012/13) and post-vaccine (two years; 2013/14–2014/15). The data sources included national rotavirus surveillance data based on laboratory reports/notifications; hospital admission data; and notifications of gastroenteritis in under 2 year olds.ResultsIn the post-vaccination period, rotavirus incidence in NI dropped by 54% while in IE it increased by 19% compared to the pre-vaccine period. Notifications of gastroenteritis in under 2 s in NI declined by 53% and hospital admissions in under 5 year olds in NI declined by 40% in the post vaccine period.ConclusionsThis natural experiment demonstrated a significant reduction in rotavirus disease activity post-vaccine introduction in NI with associated reductions in healthcare utilisation, with a concurrent increase in rotavirus disease activity in the non-vaccinated population in IE. These findings support rotavirus vaccination as an effective measure to reduce childhood morbidity. |
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| Keywords: | Rotavirus Immunisation Vaccination |
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