Rapid Declines in Age Group–Specific Rotavirus Infection and Acute Gastroenteritis Among Vaccinated and Unvaccinated Individuals Within 1 Year of Rotavirus Vaccine Introduction in England and Wales

Abstract

Background. The oral infant rotavirus vaccine, Rotarix, was introduced in England and Wales in July 2013. We estimated the impact on laboratory-confirmed rotavirus infections and hospitalizations for all-cause acute gastroenteritis (AGE) during the first year after introduction. Methods. We extracted data on laboratory-confirmed rotavirus infections (July 2000 through June 2015) and all-cause AGE–associated hospitalizations (July 2007 through June 2014) for all age groups using national databases (LabBase2 and HES). We determined the ratio of the rate during the 2013–2014 rotavirus season to the rate during the prevaccination era. Results. In infants, there was a 77% decline (rate ratio [RR], 0.23; 95% confidence interval [CI], .16–.32) in laboratory-confirmed rotavirus infections and a 26% decline (RR, 0.74; 95% CI, .65–.84) in all-cause AGE–associated hospitalizations in 2013–2014, compared with the prevaccination era. Large reductions were also observed in older children, adults, and older adults. We estimated that 10 884 laboratory-confirmed infections and 50 427 all-cause AGE–associated hospital admissions were averted in 2013–2014. Similar reductions have been observed for laboratory-confirmed rotavirus infections during the 2014–2015 season. Conclusions. The rapid declines in rotavirus infection and AGE in vaccinated and unvaccinated age groups within 1 year of introducing an infant rotavirus vaccination program are far greater than expected and than previously reported by other countries.