National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Pediatr Infect Dis J. 2010 Jun;29(6):489-94. doi: 10.1097/INF.0b013e3181d95b53.
We sought to estimate rotavirus disease reduction among children in hospital and office settings in the 4 US regions following rotavirus vaccine introduction and to estimate vaccine uptake.
Two national third-party payer medical claims databases were used to examine the number of visits for gastroenteritis per annual nongastroenteritis visits among children aged <5 years during July 2003 to June 2008 in hospital and office settings. The gastroenteritis burden attributable to rotavirus was computed as the excess of all gastroenteritis visits during rotavirus seasons above the baseline of visits during nonrotavirus periods. Rotavirus vaccine uptake was estimated by comparing claims for rotavirus vaccine with those for diphtheria-tetanus-acellular pertussis vaccines.
In the South, Northeast, and Midwest, the typical winter-spring gastroenteritis peak due to rotavirus was markedly dampened in 2007-2008. Compared with the mean for 3 prevaccine seasons, the excess gastroenteritis visits that occurred during the 2007-2008 rotavirus season was reduced by >90% among infants in all care settings in 3 regions and by >70% among children aged 1 to 4 years. In the West, disease reductions were lower (53%-63% reduction among hospitalized infants). At the onset of the 2007-2008 season, coverage with > or =1 rotavirus vaccine dose was an estimated 57% among infants, 17% among children aged 1 year, and 0 among those aged 2 to 4 years.
The rotavirus burden in 2007-2008 was markedly reduced in all US regions and exceeded that explained by only direct protection of the youngest vaccinated children.
我们旨在评估美国四个地区在轮状病毒疫苗接种后医院和门诊环境中儿童轮状病毒疾病的减少情况，并估计疫苗接种率。
我们使用了两个全国性第三方支付者医疗索赔数据库，以评估 2003 年 7 月至 2008 年 6 月期间 5 岁以下儿童每年非胃肠炎就诊次数中，胃肠炎就诊次数与非胃肠炎就诊次数的比值。通过比较轮状病毒季节期间所有胃肠炎就诊次数与非轮状病毒时期就诊次数的基线，计算出轮状病毒引起的胃肠炎负担。轮状病毒疫苗接种率通过比较轮状病毒疫苗和白喉、破伤风、无细胞百日咳疫苗的索赔来估计。
在南部、东北部和中西部，典型的冬季-春季轮状病毒胃肠炎高峰在 2007-2008 年明显减弱。与前 3 个疫苗接种季节的平均值相比，在所有护理环境中，所有年龄组婴儿在 2007-2008 年轮状病毒季节期间发生的胃肠炎就诊次数比前 3 个季节的平均值减少了超过 90%，1 至 4 岁儿童减少了超过 70%。在西部，疾病减少幅度较低（住院婴儿减少 53%-63%）。在 2007-2008 年季节开始时，估计有超过 1 剂轮状病毒疫苗的覆盖率在婴儿中为 57%，1 岁儿童中为 17%，2 至 4 岁儿童中为 0。
在所有美国地区，2007-2008 年的轮状病毒负担明显减少，超过了仅对最年轻接种儿童的直接保护所解释的负担。
