Dahl R
, et al
Protection against gastroenteritis in US households with children who received rotavirus vaccine
J Infect Dis.
; doi:

Investigators at the Centers for Disease Control and Prevention (CDC) sought to examine whether rotavirus vaccination of infants provided indirect protection against rotavirus disease among household contacts. They used information from an insurance claims database for the years 2008–2011 to compare gastroenteritis rates during January-June (“rotavirus season”) among household members in which a rotavirus vaccine-eligible child had received the vaccine with rates among those from households in which a vaccine-eligible child had not received the vaccine. To identify the population eligible for analysis, researchers first identified 3 cohorts of infants born in consecutive years between 2006 and 2009, and who were eligible to receive rotavirus vaccine (groups 1–3). Households were designated as “vaccinated” if the vaccine-eligible infant had ≥1 claim for rotavirus vaccine and “unvaccinated” if there was no claim. Medical encounters for gastroenteritis among household members were identified using ICD-9-CM codes, date, and location of service (hospitalization, emergency department [ED], or outpatient). Members were categorized into 7 age groups (0–4, 5–19, 20–29, 30–39, 40–49, 50–59, and ≥60 years) and by age with gender (for those in the 20–29 and 30–39 year age groups) to better examine likely caregivers of young children. Gastroenteritis encounters were presented per 10,000 persons during the 12-month follow-up period, and rate ratios (RR) were compared among “vaccinated” and “unvaccinated” households.

Data on approximately 90,000 households (200,000 individuals) were analyzed. Vaccine coverage increased in each consecutive cohort of infants, ranging from 56% among those born from April 2006 to July 2007 (group 1) to 77% among those born from August 2008 to July 2009 (group 3). Household size and age distribution were similar among vaccinated and unvaccinated households across all 3 groups. Rates of gastroenteritis encounters were generally highest in group 1 and lowest in group 3.

Lower rates of hospitalization and ED visits were seen in individuals from households with an infant who had been immunized. Rates of gastroenteritis-related hospitalization were significantly lower for group 1 individuals 20–29 years (RR = 0.59), females 20–29 years (RR = 0.57), and group 2 males 30–39 years (RR = 0.68). Significantly lower ED gastroenteritis rates occurred in group 2 females 20–29 years (RR = 0.84) and group 3 individuals 5–19 years (RR = 0.84). In contrast, some groups of individuals from households in which an infant had received rotavirus vaccines were at significantly increased risk for outpatient gastroenteritis.

The authors conclude that rotavirus vaccination of infants provides indirect protection against moderate-to-severe gastroenteritis in young parents and older siblings.

Dr Brady has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.

The current study examined household protection associated with infant rotavirus vaccination. Transmission of rotavirus within families from children to parents...

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