Rotavirus vaccination as a public health strategy to reduce the burden of hospitalization: The field experience of Italy (2008-2018)

J Med Virol. 2023 Aug;95(8):e29000. doi: 10.1002/jmv.29000.

Abstract

Rotavirus (RV) infection is a leading cause of severe diarrhea among children younger than 5 years old and a considerable cause of RV gastroenteritis (RVGE) hospitalization. This study aimed to evaluate the impact of vaccination in Italy in the reduction of the burden of RV-related disease, estimating the relation between vaccination coverage and hospitalization rates. RVGE-related hospitalizations that occurred in Italy from 2008 to 2018 among children aged 0-35 months were assessed by consulting the Hospital Discharge Record database and including records whose ICD-9-CM diagnosis code was 008.61 in the first or in any diagnosis position. In the 2008-2018 period, a total of 17 535 791 at-risk person-years were considered and 74 211 (423.2 cases × 100 000 per year) RVGE hospitalizations were observed. Higher hospitalization rates occurred in males (456.6 vs. 387.9 × 100 000 per year) and in children aged 1 year (507.8 × 100 000 per year). Poisson regression analysis showed a decrease of -1.25% in hospitalization rates (-1.19% to -1.31%, p < 0.001) per unit increase in vaccination coverage. This is the first study that correlates hospitalization rate reduction with a percentage increase in vaccination coverage. Our findings strongly support RV vaccination as an effective public health strategy for reducing RVGE-related hospitalizations.

Keywords: cohort study; hospitalization risk; rotavirus; vaccine.

MeSH terms

  • Child
  • Child, Preschool
  • Gastroenteritis* / epidemiology
  • Gastroenteritis* / prevention & control
  • Hospitalization
  • Humans
  • Infant
  • Italy / epidemiology
  • Male
  • Public Health
  • Rotavirus Infections* / epidemiology
  • Rotavirus Infections* / prevention & control
  • Rotavirus Vaccines*
  • Rotavirus*
  • Vaccination

Substances

  • Rotavirus Vaccines