Disease Risk – Rotavirus

 

Risk to a child from Rotavirus if not vaccinated until after the age of 5: 

Case Fatality Rate: Rotavirus causes diarrhea, which in developed countries with modern medical facilities can typically be managed medically without complication.  From 1993 to 2003, the estimated number of deaths per year in the United States in children under five from rotovirus was 37 [1].

Rate of Long Term Sequelae or Injury: There are no permanent injuries due to rotavirus infections.

Incidence Rates:  Unless children are vaccinated, almost all of them get rotavirus before their 5th birthday, however complication are rare [2]. 

Incremental Risk in Population with Low Rates of Vaccination (if a child does not vaccinate by age 5): Based on the 37 deaths per year 1993 to 2003 [1] prior to the implementation of the vaccine, the cumulative risk of death in first five years of life if a child does not vaccinate was calculated to be 0.09 deaths per 10,000 or 1 in 108,100.

Incremental Risk in Highly Vaccinated Population (if a child does not vaccinate by age 5): The Rotashield vaccine was introduced in 1998 and subsequently withdrawn in 1999.  The Rotateq vaccine was approved in 2006, and the Rotarix vaccine was approved in 2008.  There is not yet enough data following its implementation, nor are there high enough vaccination coverage rates, to assess whether there will be a herd immunity effect that would reduce the risk to an unvaccinated child [3].  Thus for this analysis, the incremental risk is assumed to be the equivalent in both analysis cases (highly-vaccinated population and population with low rates of vaccination). 

References:

[1] Kølsen Fischer,T., Viboud, C., Parashar, U., Malek, M, Steiner, C., Glass, R., Simonsen, R.  Hospitalizations and Deaths from Diarrhea and Rotavirus among Children <5 Years of Age in the United States, 1993–2003.

[2] Centers for Disease Control and Prevention.  Diseases and the Vaccines that Prevent them: Rotavirus.  http://www.cdc.gov/vaccines/vpd-vac/rotavirus/downloads/dis-rotavirus-color-office.pdf

[3] Tate, JE et al. Uptake, Impact, and Effectiveness of Rotavirus Vaccination in the United States: Review of the First 3 Years of Postlicensure Data.   Pediatric Infectious Disease Journal: January 2011 – Volume 30 – Issue 1 – pp S56-S60doi: 10.1097/INF.0b013e3181fefdc0