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Reduction in Gastroenteritis in United States Children and Correlation With Early Rotavirus Vaccine Uptake From National Medical Claims Databases

Cortese, Margaret M. MD*; Tate, Jacqueline E. PhD, MSPH*; Simonsen, Lone PhD†‡; Edelman, Laurel BSc; Parashar, Umesh D. MB BS, MPH*

The Pediatric Infectious Disease Journal: June 2010 - Volume 29 - Issue 6 - p 489-494
doi: 10.1097/INF.0b013e3181d95b53
Original Studies

Background: We sought to estimate rotavirus disease reduction among children in hospital and office settings in the 4 US regions following rotavirus vaccine introduction and to estimate vaccine uptake.

Methods: Two national third-party payer medical claims databases were used to examine the number of visits for gastroenteritis per annual nongastroenteritis visits among children aged <5 years during July 2003 to June 2008 in hospital and office settings. The gastroenteritis burden attributable to rotavirus was computed as the excess of all gastroenteritis visits during rotavirus seasons above the baseline of visits during nonrotavirus periods. Rotavirus vaccine uptake was estimated by comparing claims for rotavirus vaccine with those for diphtheria-tetanus-acellular pertussis vaccines.

Results: In the South, Northeast, and Midwest, the typical winter-spring gastroenteritis peak due to rotavirus was markedly dampened in 2007–2008. Compared with the mean for 3 prevaccine seasons, the excess gastroenteritis visits that occurred during the 2007–2008 rotavirus season was reduced by >90% among infants in all care settings in 3 regions and by >70% among children aged 1 to 4 years. In the West, disease reductions were lower (53%–63% reduction among hospitalized infants). At the onset of the 2007–2008 season, coverage with ≥1 rotavirus vaccine dose was an estimated 57% among infants, 17% among children aged 1 year, and 0 among those aged 2 to 4 years.

Conclusions: The rotavirus burden in 2007–2008 was markedly reduced in all US regions and exceeded that explained by only direct protection of the youngest vaccinated children.


From the *National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA; †SDI Health, LLC, Plymouth Meeting, PA; and ‡Department of Global Health, George Washington University, Washington, DC.

Accepted for publication November 20, 2009.

The findings and conclusions of this article are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

M.C., J.T., U.P. report no conflicts of interest. L.E. is employed by SDI Health, LLC. L.S. reports the following: SDI, consulting services—received consulting payment; Wyeth, research grant—received consulting payment; Roche, advisory—received consulting payment; Merck, advisory—received consulting payment.

Address for correspondence: Margaret M. Cortese, MD, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, MS-A47, Atlanta, GA 30333. E-mail:

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© 2010 Lippincott Williams & Wilkins, Inc.