Cocontribution of Rotavirus and Pneumococcal Conjugate Vaccines to the Reduction of Pediatric Hospital Visits in Young Children.
OBJECTIVE
To assess rotavirus vaccine and pneumococcal conjugate vaccines (PCVs) cumulative impact on the pediatric emergency department visits and hospitalization rates in children <2 years of age in southern Israel between April 2006 and March 2014.


STUDY DESIGN
This prospective, population-based observational study calculated the rates of rotavirus gastroenteritis (RVGE), non-RVGE, community-acquired alveolar pneumonia (CAAP), nonalveolar lower respiratory tract infection, and all-cause hospital visits. PCV7, PCV13, and rotavirus vaccination programs were implemented in Israel in July 2009, November 2010, and January 2011, respectively.


RESULTS
From 2006-2009 to 2013-2014, the rates of hospitilizations for RVGE, non-RVGE, CAAP, and nonalveolar lower respiratory tract infection decreased by 78%, 21%, 46%, and 7%, respectively. In outpatients, the respective decreases were 80%, 16%, 67%, and 14%. All-cause outpatient pediatric emergency department visits and hospitalization rates were reduced by 12% and 11%, respectively. During the peak season (October through March), RVGE, non-RVGE, CAAP, and nonalveolar lower respiratory tract infection hospitalization rates decreased significantly by 86%, 44.6%, 23.3%, and 10.5%, respectively. In outpatients, the respective decreases were 81.7%, 73.5%, 13.8%, and 10.7%. The proportion of RVGE and CAAP (grouped) of all-cause hospitalizations and outpatient pediatric ED visits decreased from 19.9% to 12.3% and from 6.9% to 1.8%, respectively.


CONCLUSIONS
Rotavirus vaccine and PCV introduction cocontributed to a rapid, considerable reduction in hospital burden in children <2 years of age. Because seasonalities of both diseases overlap, this reduction is particularly helpful in relieving burdens of disease and care during the most cumbersome morbidity season.
['Ben-Shimol|Shalom|S|', 'Givon-Lavi|Noga|N|', 'Greenberg|David|D|', 'Dagan|Ron|R|']
D000367:Age Factors D002675:Child, Preschool D015331:Cohort Studies D016001:Confidence Intervals D004636:Emergency Service, Hospital D005260:Female D006776:Hospitals, Pediatric D006801:Humans D015994:Incidence D007223:Infant D007557:Israel D008297:Male D016017:Odds Ratio D017063:Outcome Assessment, Health Care D011008:Pneumococcal Infections D022242:Pneumococcal Vaccines D011446:Prospective Studies D018570:Risk Assessment D012400:Rotavirus Infections D022243:Rotavirus Vaccines D017678:Sex Distribution D012737:Sex Factors D014611:Vaccination
health care service utilization immunization infectious disease burden