Rotavirus and pneumococcal conjugate vaccines reduce pediatric hospital burden

"Our findings confirm the utmost importance of co-contribution of pneumococcal and rotavirus vaccines in reduction of burden of severe diarrhea and respiratory diseases reduction, especially during winter, the season with peak hospitalization rates of young children," said principal investigator, Ron Dagan, MD, Professor of Pediatrics and Infectious Diseases at the Pediatric Infectious Disease Unit, Soroka University Medical Center, Israel.

Winter respiratory and diarrheal diseases in infants and young children are often due to infections caused by the bacterium Streptococcus pneumoniae (the pneumococcus) and the rotavirus, respectively. New vaccines against pneumococcus (pneumococcal conjugate vaccines [PCVs]) and against rotavirus were recently introduced and each showed great impact on the disease it was addressed to reduce. However, the combined impact resulting from the introduction of both vaccines on hospital burden, especially during the very busy fall and winter season, was not fully studied.

This study aimed to observe the combined effect of the co-administration of PCVs and rotavirus vaccines was part of an enhanced prospective surveillance which took place in southern Israel, by the group led by Ron Dagan, MD, from the Pediatric Infectious Disease Unit of the Soroka University Medical Center and the Faculty of Health Sciences at the Ben-Gurion University in Beer-Sheva, Israel.

Within <5 years from introduction, the rate of hospital admission due to rotavirus diarrhea in children younger than 2 years dropped by 78% and that of children < 2 years with X-ray proven pneumonia dropped by 46%. For outpatient visits these figures were 80% and 67%, respectively. These figures translate into reduction of 21.5 yearly pediatric hospitalizations per 1000 children <2 years (11.1 and 10.4 visits for diarrhea and respiratory diseases, respectively), and 20.7 yearly Emergency-room visits per 1000 children < 2 years (11.4 and 9.3 for diarrhea and respiratory infections, respectively).

Extrapolated to the birth cohort in the USA (~4 million births), the yearly reduction in hospitalization burden for respiratory infection and diarrhea is ~86,000 and for pediatric outpatient emergency visits it is ~82,500 episodes (reducing altogether ~168,000 hospital visits yearly). Moreover, >70% of these numbers are during the late fall and the winter months -- where most of hospitalization burden occurs in young children.

The study was funded in part by the rotavirus and pneumocccal vaccine manufacturers, and was a part of the evaluation plan of vaccine introduction of the Israel Ministry of Health.