Pediatrics
February 2011 / VOLUME 127 / ISSUE 2
http://pediatrics.aappublications.org/current.shtml

Articles
Impact of Rotavirus Vaccination on Hospital-Acquired Rotavirus Gastroenteritis in Children
Evan J. Anderson, Angela Rupp, Stanford T. Shulman, Deli Wang, Xiaotian Zheng, and Gary A. Noskin
Pediatrics 2011; 127: e264-e270.

OBJECTIVE Data show that after the implementation of routine rotavirus vaccination for infants in the United States, community-acquired (CA) rotavirus cases declined substantially in the 2007–2008 season. The impact of community-based rotavirus vaccination on the substantial burden of hospital-acquired (HA) rotavirus has not been documented.

PATIENTS AND METHODS We assessed CA and HA rotavirus, respiratory syncytial virus, and influenza infections at Children’s Memorial Hospital for 5 winter seasons (defined as occurring from September through May) from 2003 to 2008. We also report rotavirus data from the 2008–2009 season.

RESULTS A similar dramatic decline (>60% compared with the median of previous seasons) occurred in the rates of cases of both CA (P < .0001) rotavirus hospitalizations and HA (P < .01) rotavirus infections in the 2007–2008 season compared with previous seasons, whereas the rates of CA and HA influenza and respiratory syncytial virus, respectively, remained stable. Improvements in hand-hygiene compliance did not correlate with a reduction in the transmission rate of rotavirus in the hospital. Both CA and HA rotavirus rates remained much lower in the 2008–2009 than in the 2003–2007 seasons.

CONCLUSIONS Community-based rotavirus vaccination is associated with a substantial reduction in the number of children who are admitted with rotavirus. These data also indicate that routine community-based rotavirus infant vaccination protects hospitalized children from acquiring rotavirus. Vaccination efforts should be encouraged as a strategy to affect the substantial burden of HA rotavirus.