If fewer babies in the U.S. get the rotavirus vaccine, thousands more children could end up in the hospital or emergency department each year with severe diarrhea and vomiting by age 2, according to a new modeling study led by a WashU Medicine researcher published Oct. 26 in JAMA Network Open.
Rotavirus is one of several viruses that can cause gastroenteritis — inflammation of the stomach and intestines with symptoms including vomiting, fever, watery diarrhea and abdominal pain — and is a leading cause of severe diarrheal illness in young children. In January, the Centers for Disease Control and Prevention (CDC) dropped its recommendation to routinely vaccinate infants against rotavirus in favor of “shared clinical decision-making” between clinicians and families. A federal judge temporarily blocked the change in March.
To estimate what the shift in CDC guidance could mean for children younger than 2, Anne Mobley Butler, PhD, an associate professor in WashU Medicine’s Division of Infectious Diseases in the John T. Milliken Department of Medicine, and collaborators at Duke University modeled what would happen if 10%, 20% or 30% of U.S. infants who would be fully vaccinated against rotavirus based on current vaccination rates didn’t get the vaccine, which is typically given between 2 and 6 months. They estimated that for each year’s group of newborns there would be an additional 1,500 to 4,500 hospitalizations and 4,400 to 13,200 emergency department visits by age 2. Those visits would add $34.5 million to $103.5 million in healthcare costs, and the burden would grow with every new year of births.
The researchers noted that the actual numbers of additional healthcare encounters would likely be higher, because their model did not count outpatient visits or account for the way vaccinated children protect unvaccinated ones by reducing spread. Before routine vaccination began in 2006, about 80% of U.S. children were infected with rotavirus by age 5, and the virus caused more than 55,000 hospitalizations each year among children younger than five.
The researchers built a free online tool that lets users explore how changes in the current vaccination rate and other assumptions affect the results. The team leveraged risk estimates of severe gastroenteritis-related hospitalizations and emergency department visits among fully vaccinated, partially vaccinated and unvaccinated infants from their previous work.