scholarly journals Change in incidence of clinic visits for all-cause and rotavirus gastroenteritis in young children following the introduction of universal rotavirus vaccination in Israel

2015 ◽  
Vol 20 (42) ◽  
Author(s):  
Khitam Muhsen ◽  
Gabriel Chodick ◽  
Sophy Goren ◽  
Emilia Anis ◽  
Tomer Ziv-Baran ◽  
...  
Keyword(s):  
Age Groups ◽  
Real World Data ◽  
Health Maintenance ◽  
Rotavirus Vaccination ◽  
Rotavirus Gastroenteritis ◽  
Rotavirus Vaccines ◽  
Laboratory Surveillance ◽  
Antigen Tests ◽  
The Impact ◽  
Clinic Visits

Both rotavirus vaccines RotaTeq and Rotarix were efficacious against severe rotavirus gastroenteritis in clinical trials; yet real-world data on the effect of rotavirus vaccines on mild to moderate disease are limited. We used a large computerised database of Maccabi Health Services Health Maintenance Organisation (HMO), the second largest HMO in Israel covering 25% of the Israeli population, to compare the incidence of acute gastroenteritis (AGE) clinic visits in community settings (n = 302,445) before (2005–10) and after (2011–13) the introduction of universal rotavirus immunisation in Israel. We retrieved laboratory results of rotavirus antigen tests (n = 18,133) and using a weighted analysis, we estimated the impact of rotavirus immunisation on the disease burden of rotavirus AGE clinic visits. Following the introduction of universal rotavirus immunisation, the typical winter peaks of rotavirus AGE were substantially lower and significant reductions of 14.8% (95% confidence interval (CI): 13.5–16.1) in all-cause AGE clinic visits and of 59.7% (95% CI: 59.8–62.6) in rotavirus AGE clinic visits were observed. The decrease was observed in all age groups, but it was greater in children aged 0 to 23 months than those aged 24 to 59 months. Continued rotavirus laboratory surveillance is warranted to monitor the sustainability of these changes.

scholarly journals Epidemiology of Rotavirus Gastroenteritis and Rotavirus-Associated Benign Convulsions with Mild Gastroenteritis after the Introduction of Rotavirus Vaccines in South Korea: Nationwide Data from the Health Insurance Review and Assessment Service

2020 ◽  
Vol 17 (22) ◽  
pp. 8374
Author(s):  
Dong Hyun Kim ◽  
Yeong Seok Lee ◽  
Dong Jun Ha ◽  
Min Jun Chun ◽  
Young Se Kwon
Keyword(s):  
Health Insurance ◽  
South Korea ◽  
Rural Areas ◽  
Information Service ◽  
Geographic Location ◽  
Rotavirus Vaccination ◽  
Rotavirus Gastroenteritis ◽  
Rotavirus Vaccines ◽  
Annual Prevalence ◽  
The Impact

Using nationwide data from the Health Insurance Review and Assessment service, we assessed the impact of rotavirus vaccines, introduced in South Korea, in 2007, on changes in the prevalence of factors (age, sex, and geographic location) associated with rotavirus gastroenteritis (RVGE) and rotavirus-associated benign convulsions with mild gastroenteritis (RaCwG). We analyzed health records of children younger than 3 years who visited clinical facilities and were diagnosed with RVGE or RaCwG between 2007 and 2019. The annual mid-year population (MYP) was obtained from the Korean Statistical Information Service. The annual prevalence of RVGE, RaCwG and associated factors were statistically analyzed. Overall, 219,686, and 4032, children were confirmed to have RVGE and RaCwG, respectively. Although the annual prevalence of RVGE decreased significantly, that of RaCwG did not. The annual ratio of RaCwG to RVGE was significantly high. Compared to the prevalence of RVGE, the prevalence of RaCwG was significantly lower in rural areas. The age of RaCwG patients was significantly lower than that of the MYP and that of RVGE patients. The decrease in the number of RaCwG patients after rotavirus vaccination was not as pronounced as the decrease in the number of RVGE patients.

One-Dose Human Papillomavirus Vaccination and the Risk of Genital Warts: A Danish Nationwide Population-based Study

2020 ◽  
Author(s):  
Louise Baandrup ◽  
Christian Dehlendorff ◽  
Susanne K Kjaer
Keyword(s):  
Human Papillomavirus ◽  
Hpv Vaccination ◽  
Age Groups ◽  
Genital Warts ◽  
Population Based ◽  
Incidence Rates ◽  
Real World Data ◽  
Calendar Time ◽  
Human Papillomavirus Vaccination ◽  
The Impact

Abstract Background Increasing evidence suggests that 1-dose human papillomavirus (HPV) vaccination may protect significantly against HPV-related disease. We provide nationwide, real-world data on the risk of genital warts (GWs) after <3 vaccine doses. Methods All Danish women born in 1985–2003 were identified, and individual-level vaccination data were retrieved. The cohort was followed up for first occurrence of GWs until 31 December 2016. Using Poisson regression, we calculated incidence rates (IRs) of GWs per 100 000 person-years and IR ratios (IRRs) with corresponding 95% confidence intervals (CIs) for GWs, according to vaccination status, age at first dose, and calendar time. Results The cohort comprised 1 076 945 girls and women, of whom 485 408 were vaccinated. For girls initiating vaccination at age 12–14 years and 15–16 years, 1-dose vaccine effectiveness (VE) was 71% (IRR = 0.29; 95% CI, .22–.38) and 62% (0.38; .29–.49), respectively, compared with unvaccinated girls. In the same age groups, 2-dose VE was 78% (IRR, 0.22; 95% CI, .18–.26) and 68% (0.32; .26–.38), respectively. After 2009, the IRRs for 3 versus 1 dose and 2 versus 1 dose increased towards unity over calendar time, being 0.69 (95% CI, .57–.84) and 0.86 (.68–1.08) in 2016, respectively. Conclusions In this study, 1 or 2 doses of quadrivalent HPV vaccine was associated with substantial protection against GWs in girls vaccinated at age ≤16 years. The 1-dose VE approached that of 3 or 2 doses over calendar time, probably reflecting the impact of herd protection.

scholarly journals Clinical laboratory practices for the detection of rotavirus in England and Wales: can surveillance based on routine laboratory testing data be used to evaluate the impact of vaccination?

2009 ◽  
Vol 14 (20) ◽  
Author(s):  
C J Atchison ◽  
B A Lopman ◽  
C J Harris ◽  
C C Tam ◽  
M Iturriza Gómara ◽  
...  
Keyword(s):  
Laboratory Testing ◽  
Clinical Laboratory ◽  
Age Groups ◽  
Surveillance Data ◽  
Enzyme Linked Immunosorbent Assay ◽  
Routine Laboratory ◽  
England And Wales ◽  
Rotavirus Vaccines ◽  
Testing Data ◽  
The Impact

Two rotavirus vaccines have recently been licensed in Europe. Rotavirus surveillance data in many European countries are based on reports of laboratory-confirmed rotavirus infections. If surveillance data based on routine laboratory testing data are to be used to evaluate the impact of vaccination programmes, it is important to determine how the data are influenced by differences in testing practices, and how these practices are likely to affect the ability of the surveillance data to represent trends in rotavirus disease in the community. We conducted a survey of laboratory testing polices for rotavirus gastroenteritis in England and Wales in 2008. 60% (94/156) of laboratories responded to the survey. 91% of reporting laboratories offered routine testing for rotavirus all year round and 89% of laboratories offered routine rotavirus testing of all stool specimens from children under the age of five years. In 96% of laboratories, rotavirus detection was presently done either by rapid immunochromatographic tests or by enzyme-linked immunosorbent assay. Currently, rotavirus testing policies among laboratories in England and Wales are relatively homogenous. Therefore, surveillance based on laboratory testing data is likely to be representative of rotavirus disease trends in the community in the most frequently affected age groups (children under the age of five years) and could be used to help determine the impact of a rotavirus vaccine.

scholarly journals Impact of infant pneumococcal vaccination on invasive pneumococcal diseases in France, 2001-2006

2008 ◽  
Vol 13 (35) ◽  
Author(s):  
A Lepoutre ◽  
E Varon ◽  
S Georges ◽  
L Gutmann ◽  
D Lévy-Bruhl
Keyword(s):  
Pneumococcal Meningitis ◽  
Age Groups ◽  
Pneumococcal Vaccination ◽  
Early Observation ◽  
Older Children ◽  
Vaccine Serotypes ◽  
Time Period ◽  
Laboratory Surveillance ◽  
Pneumococcal Bacteraemia ◽  
The Impact

Vaccination with the 7-valent pneumococcal conjugate vaccine (PCV) has been recommended in France since 2003 for children under the age of two years who are at risk due to medical or living conditions. From 2006, the recommendation has been extended to all children under two years. The impact of PCV introduction on the incidence of pneumococcal meningitis and bacteraemia and on the serotype distribution in French children and other age-groups was assessed using laboratory surveillance data. The coverage with three doses of PCV was 44% in children aged 6-12 months in 2006. From 2001/2002 to 2006, the incidence of pneumococcal meningitis decreased from 8.0 to 6.0 cases per 100,000, and the incidence of pneumococcal bacteraemia decreased from 21.8 to 17.5 cases per 100,000 in children under the age of two years. For the vaccine strains, the incidence of pneumococcal meningitis and bacteraemia decreased from 20,4 to 6.0 cases per 100,000, while the incidence of pneumococcal meningitis and bacteraemia due to non-vaccine strains increased from 9.4 to 17.5 cases per 100,000 in this time period. The incidence in older children and adults did not decrease. Further expansion of PCV coverage is expected to increase the impact of the vaccination in both children and adults. However, the fact that cases caused by vaccine serotypes have been partially substituted by cases of non-vaccine serotypes is likely to reduce the overall benefit of PCV in France, should this early observation be confirmed in the future.

scholarly journals The impact of rotavirus vaccination in the prevalence of gastroenteritis and comorbidities among children after suboptimal rotavirus vaccines implementation in Taiwan

Medicine ◽  
2021 ◽  
Vol 100 (25) ◽  
pp. e25925
Author(s):  
Meng-Che Lu ◽  
Ben-Chang Shia ◽  
Yi-Wei Kao ◽  
Sheng-Chieh Lin ◽  
Chuan-Yu Wang ◽  
...  
Keyword(s):  
Rotavirus Vaccination ◽  
Rotavirus Vaccines ◽  
The Impact

scholarly journals Accounting for indirect protection in the benefit–risk ratio estimation of rotavirus vaccination in children under the age of 5 years, France, 2018

2020 ◽  
Vol 25 (33) ◽  
Author(s):  
Sylvie Escolano ◽  
Judith E Mueller ◽  
Pascale Tubert-Bitter
Keyword(s):  
Risk Ratio ◽  
Case Fatality ◽  
Claim Data ◽  
Simulation Design ◽  
Uncertainty Interval ◽  
Rotavirus Vaccination ◽  
Rotavirus Gastroenteritis ◽  
Rotavirus Vaccines ◽  
Risk Balance ◽  
Indirect Protection

Background Rotavirus is a major cause of severe gastroenteritis in children worldwide. The disease burden has been substantially reduced in countries where rotavirus vaccines are used. Given the risk of vaccine-induced intussusception, the benefit–risk balance of rotavirus vaccination has been assessed in several countries, however mostly without considering indirect protection effects. Aim We performed a benefit–risk analysis of rotavirus vaccination accounting for indirect protection in France among the 2018 population of children under the age of 5 years. Methods To incorporate indirect protection effects in the benefit formula, we adopted a pseudo-vaccine approach involving mathematical approximation and used a simulation design to provide uncertainty intervals. We derived background incidence distributions from quasi-exhaustive health claim data. We examined different coverage levels and assumptions regarding the waning effects and intussusception case fatality rate. Results With the current vaccination coverage of < 10%, the indirect effectiveness was estimated at 6.4% (+/− 0.4). For each hospitalisation for intussusception, 277.0 (95% uncertainty interval: (165.0–462.1)) hospitalisations for rotavirus gastroenteritis were prevented. Should 90% of infants be vaccinated, indirect effectiveness would reach 57.9% (+/− 3.7) and the benefit–risk ratio would be 192.4 (95% uncertainty interval: 116.4–321.3). At a coverage level of 50%, indirect protection accounted for 27% of the prevented rotavirus gastroenteritis cases. The balance remained in favour of the vaccine even in a scenario with a high assumption for intussusception case fatality. Conclusions These findings contribute to a better assessment of the rotavirus vaccine benefit–risk balance.

Psychiatric adverse drug reactions in the paediatric population

2020 ◽  
Vol 105 (8) ◽  
pp. 749-755 ◽  
Author(s):  
Corine Ekhart ◽  
Tjalling de Vries ◽  
Florence van Hunsel
Keyword(s):  
Adverse Drug Reactions ◽  
Product Information ◽  
Age Groups ◽  
Well Being ◽  
Paediatric Population ◽  
Pharmacovigilance Centre ◽  
Drug Reactions ◽  
Real World Data ◽  
Lack Of Information ◽  
The Impact

ObjectiveDue to lack of information on drug use in children, many drugs are used off-label in paediatrics. Increased knowledge of adverse drug reactions (ADRs) would enable a better risk–benefit analysis. Our aim was to characterise drugs causing psychiatric ADRs in children by conducting a descriptive study based on pharmacovigilance reports.DesignReports submitted to the Netherlands Pharmacovigilance Centre Lareb from 2003 to 2016 were used to investigate drugs causing psychiatric ADRs in the Dutch paediatric population. These data were corrected for drug utilisation in order to correct the number of reports for the number of users of a drug.Main outcome measuresORs were calculated as a measure of disproportionality for drug–ADR associations for three different age groups. Significant drug–ADR associations were checked if it was labelled in the product information.ResultsLareb received 918 reports of psychiatric ADRs, which constitute 15% of the reports of ADRs in children. Drugs used for the treatment of ADHD (methylphenidate and atomoxetine) and drugs used for the treatment of asthma (montelukast and fluticasone) were the most frequently reported. However, psychiatric ADRs were also reported for less often prescribed medications such as oxybutynin and isotretinoin.ConclusionsReal-world data on psychiatric ADRs in the Dutch paediatric population show a consistent pattern with what is known from drug labels and the literature. Reports of psychiatric ADRs should be taken seriously because of the impact on medication adherence and the well-being of the child and its family.

scholarly journals P609 Impact of accessibility of medical care and socioeconomic class on outcomes of IBD – a nationwide population study

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S554-S554
Author(s):  
O Ledder ◽  
S Harel ◽  
E Orlanski-Meyer ◽  
D Yogev ◽  
Y Loewenberg Weisband ◽  
...  
Keyword(s):  
Medical Care ◽  
Population Study ◽  
Physical Distance ◽  
Northern Region ◽  
Southern Region ◽  
Health Maintenance ◽  
Steroid Dependency ◽  
Central Regions ◽  
The Impact ◽  
Clinic Visits

Abstract Background Despite ongoing improvements in Inflammatory Bowel Disease (IBD) therapeutics, timely access to quality medical care likely impacts patient outcomes. Physical distance from specialty care and socioeconomic status (SES) may impact quality of care. In a nationwide population study we aimed to assess the impact of patient location and SES on IBD outcomes. Methods This Epi-IIRN project utilized a meta-database incorporating patient data of all four health maintenance organisations (HMO) in Israel, representing 98% of the population. All patients identified on the incidence cohort were followed from diagnosis until end of 2018. Regions in Israel were defined as central (coastal plain and Jerusalem corridor), northern region and southern region. SES class were defined by postcode as per Israel bureau of statistics data from SES 1 (lowest) to SES 4 (highest). Primary outcome was steroid dependency, with secondary outcomes of biologic therapy use during first year of diagnosis, surgery, gastroenterology visits, hospitalizations and mortality. Analysis was performed separately for Crohn’s disease (CD) and ulcerative colitis (UC). Results A total of 30,167 IBD patients (16,936 (56%) CD and 13,231 (44%) UC) were included: 74% of patients were in central region, 12% southern region and 14% northern region. 21% were in SES class 1 and 12% in SES 4. In CD, lower SES was associated with higher steroid dependency (37% vs 30%, p=0.002), higher surgery rates (21% vs 12%, p&lt;0.001), more hospitalizations (2.4 vs 1.1, p&lt;0.001), more emergency department (ER) visits (2.9 vs 1.9, p&lt;0.001) and higher mortality (3.3% vs 2.5%, p=0.03). Regarding region, steroid dependency, hospitalization rate, ER visits and surgery rate were all lower in central regions compared to both northern and southern region (p&lt;0.001 for both central vs northern, and central vs southern regions). Similarly, gastrointestinal specialized clinic visits were more frequent in central regions (p=0.01). In UC, lower SES was associated with lower frequency of gastrointestinal clinic visits (5.0 vs 8.5, p&lt;0.001). This was associated with more hospitalizations (1.6 vs 0.7, p&lt;0.001), ER visits (2.1 vs 1.6, p=0.002), surgeries (7.6% vs 5.0%, p=0.014) and higher mortality (5.1% vs 4.2%, p=0.026). By region, gastrointestinal clinic visits were more frequent, and ER visits, hospitalizations (all p&lt;0.001) and surgeries (p=0.001) were all lower in central compared to both northern and southern regions. Conclusion In this nationwide analysis we show deleterious impact of both lower SES and peripheral residence on outcomes of CD and UC. Policy makers should consider these data to facilitate improved access to medical care and maximize IBD outcomes in a standardized way.

scholarly journals Sustained low rotavirus activity and hospitalisation rates in the post-vaccination era in Belgium, 2007 to 2014

2016 ◽  
Vol 21 (27) ◽  
Author(s):  
Martine Sabbe ◽  
Nicolas Berger ◽  
Adriaan Blommaert ◽  
Benson Ogunjimi ◽  
Tine Grammens ◽  
...  
Keyword(s):  
Herd Immunity ◽  
Vaccination Schedule ◽  
Vaccine Uptake ◽  
Age Group ◽  
The European Union ◽  
Post Vaccination ◽  
Rotavirus Vaccination ◽  
Rotavirus Gastroenteritis ◽  
The Impact ◽  
Vaccination Period

In 2006, Belgium was the first country in the European Union to recommend rotavirus vaccination in the routine infant vaccination schedule and rapidly achieved high vaccine uptake (86–89% in 2007). We used regional and national data sources up to 7 years post-vaccination to study the impact of vaccination on laboratory-confirmed rotavirus cases and rotavirus-related hospitalisations and deaths. We showed that (i) from 2007 until 2013, vaccination coverage remained at 79–88% for a complete course, (ii) in children 0–2 years, rotavirus cases decreased by 79% (95% confidence intervals (CI): 68–­89%) in 2008–2014 compared to the pre-vaccination period (1999–­2006) and by 50% (95% CI: 14–82%) in the age group ≥ 10 years, (iii) hospitalisations for rotavirus gastroenteritis decreased by 87% (95% CI: 84–90%) in 2008–­2012 compared to the pre-vaccination period (2002–­2006), (iv) median age of rotavirus cases increased from 12 months to 17 months and (v) the rotavirus seasonal peak was reduced and delayed in all post-vaccination years. The substantial decline in rotavirus gastroenteritis requiring hospitalisations and in rotavirus activity following introduction of rotavirus vaccination is sustained over time and more pronounced in the target age group, but with evidence of herd immunity.

scholarly journals Spatio-Temporal Impact of Self-Financed Rotavirus Vaccination on Rotavirus and Acute Gastroenteritis Hospitalisations in the Valencia Region, Spain.

2020 ◽  
Author(s):  
Mónica López-Lacort ◽  
Alejandro Orrico-Sánchez ◽  
Miguel Ángel Martínez-Beneito ◽  
Cintia Muñoz-Quiles ◽  
Javier Díez-Domingo
Keyword(s):  
Acute Gastroenteritis ◽  
Hospital Admissions ◽  
Vaccine Coverage ◽  
Population Based ◽  
Space Time ◽  
Real World Data ◽  
Substantial Impact ◽  
Rotavirus Vaccination ◽  
Spatio Temporal ◽  
The Impact

Abstract Background: Several studies have shown a substantial impact of Rotavirus (RV) vaccination on the burden of RV and all-cause acute gastroenteritis (AGE). However, the results of most impact studies could be confused by a dynamic and complex space-time process. Therefore, there is a need to analyse the impact of RV vaccination on RV and AGE hospitalisations in a space-time framework to detect geographical-time patterns while avoiding the potential confusion caused by population inequalities in the impact estimations.Methods: A retrospective population-based study using real-world data from the Valencia Region was performed among children aged less than 3 years old in the period 2005-2016. A Bayesian spatio-temporal model was constructed to analyse RV and AGE hospitalisations and to estimate the vaccination impact measured in averted hospitalisations. Results: We found important spatio-temporal patterns in RV and AGE hospitalisations, RV vaccination coverage and in their associated adverted hospitalisations. Overall, ~1866 hospital admissions for RV were averted by RV vaccination during 2007–2016. Despite the low-medium vaccine coverage (~50%) in 2015-2016, relevant 36% and 20% reductions were estimated in RV and AGE hospitalisations respectively.Conclusions: The introduction of the RV vaccines has substantially reduced the number of RV hospitalisations, averting ~1866 admissions during 2007-2016 which were space and time dependent. This study improves the methodologies commonly used to estimate the RV vaccine impact and their interpretation.

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