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Impact of rotavirus vaccine on acute g.stroenteritis emerg.ncy department visits and hospitalizations in a hig.ly-vaccinated urban cohort

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Open Journal of Pediatrics 2011年第4期1卷 41-44页

作者： Sheila M. Nolan Priya Prasad alexander g. fiks Theoklis E. Zaoutis Thomas R. TenHave Susan E. Coffin 不详

Backg.ound: Rotavirus vaccines (RVV) have sig.ificantly reduced rotavirus disease in children over the past 4 years in the United States. In this study, we describe the impact of RVV in preventing.acute g.stroenteritis (Ag.) hospital encounters in a hig.ly-vaccinated urban pediatric network during.the 2007 and 2008 rotavirus seasons. Methods: We used 5 urban practices from a practice-based network to conduct a retrospective cohort study comparing.the numbers of Ag. emerg.ncy department (ED) visits and hospitalizations in RVV-immunized (exposed) and non-immunized (unexposed) children during.the first 2 full seasons following.RVV introduction. We determined incident rate ratios (IRR), using.Poisson reg.ession, and vaccine effectiveness for each outcome. Results: The 2007 and 2008 cohorts were analyzed separately. 62% of the 2007 cohort was vaccinated and 88% of the 2008 cohort. Ag. hospitalizations were sig.ificantly reduced among.RVV-immunized children from the 2007 cohort in the 2008 season with vaccine effectiveness of 67%. Sub-analysis of this cohort by ag. revealed that RVV was most protective ag.inst hospitalizations in the young.st ag. g.oup (IRR = 0.21, 95% CI (0.06, 0.82). A trend toward protection ag.inst hospitalization was detected for both cohorts in the first season following.immunization that did not reach a statistically sig.ificant level. For Ag. ED visits, no sig.ificant difference was seen between RVV-immunized and non-immunized children in either cohort, althoug. there was a trend toward protection (IRR’s: 0.67 - 0.7). Conclusions: RVV was hig.ly effective in preventing.Ag. hospitalizations for a subset of our cohort in 2008. g.ven reports of RVV effectiveness, we hypothesize that herd immunity is responsible for the inability to detect a sig.ificant difference between RVV-immunized and non-immunized children in our hig.ly- vaccinated cohort.

关键词： Rotavirus Pediatrics Acute g.stroenteritis

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