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Impact of the national rotavirus vaccination programme on acute gastroenteritis in England and associated costs averted.

Thomas, SL; Walker, JL; Fenty, J; Atkins, KE; Elliot, AJ; Hughes, HE; Stowe, J; Ladhani, S; Andrews, NJ (2017) Impact of the national rotavirus vaccination programme on acute gastroenteritis in England and associated costs averted. Vaccine, 35 (4). pp. 680-686. ISSN 1873-2518 https://doi.org/10.1016/j.vaccine.2016.11.057
SGUL Authors: Ladhani, Shamez Nizarali

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Abstract

BACKGROUND: Introduction of infant oral rotavirus vaccination in the UK in July 2013 has resulted in decreased hospitalisations and Emergency Department (ED) visits for acute gastroenteritis (AGE), for both adults and children. We investigated reductions in AGE incidence seen in primary care in the two years after vaccine introduction, and estimated the healthcare costs averted across healthcare settings in the first year of the vaccination programme. METHODS: We used primary care data from the Clinical Practice Research Datalink and age-stratified time-series analyses to derive adjusted incidence rate ratios (IRRa) for AGE in the first two years of the post-vaccination era (July 2013-April 2015) compared to the pre-vaccination era (July 2008-June 2013). We estimated cases averted among children aged <5years in the first year of the vaccination programme by comparing observed numbers of AGE cases in 2013-2014 to numbers predicted from the time-series models. We then estimated the healthcare costs averted for general practice consultations, ED visits and hospitalisations. RESULTS: In general practice, AGE rates in infants (the target group for vaccination) decreased by 15% overall after vaccine introduction (IRRa=0.85; 95%CI=0.76-0.95), and by 41% in the months of historically high rotavirus circulation (IRRa=0.59; 95%CI=0.53-0.66). Rates also decreased in other young children and to a lesser degree in older individuals, indicating herd immunity. Across all three settings (general practice, EDs, and hospitalisations) an estimated 87,376 (95% prediction interval: 62,588-113,561) AGE visits by children aged <5years were averted in 2013-14, associated with an estimated £12.5million (9,209-16,198) reduction in healthcare costs. CONCLUSIONS: The marked decreases in the general practice AGE burden after rotavirus vaccine introduction mirror decreases seen in other UK healthcare settings. Overall, these decreases are associated with substantial averted healthcare costs.

Item Type: Article
Additional Information: © 2016 The Authors. Published by Elsevier Ltd. This is an open access article under the CCBY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Keywords: Electronic health records, Gastroenteritis, Health care costs, Primary health care, Rotavirus, Vaccination, Electronic health records, Gastroenteritis, Health care costs, Primary health care, Rotavirus, Vaccination, Virology, 06 Biological Sciences, 07 Agricultural And Veterinary Sciences, 11 Medical And Health Sciences
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: Vaccine
ISSN: 1873-2518
Language: eng
Dates:
DateEvent
23 January 2017Published
20 December 2016Published Online
15 November 2016Accepted
Publisher License: Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0
PubMed ID: 28007397
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/108538
Publisher's version: https://doi.org/10.1016/j.vaccine.2016.11.057

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