Rotavirus vaccination as a public health strategy to reduce the burden of hospitalization: The field experience of Italy (2008−2018)

Abstract

AbstractRotavirus (RV) infection is a leading cause of severe diarrhea among children younger than 5 years old and a considerable cause of RV gastroenteritis (RVGE) hospitalization. This study aimed to evaluate the impact of vaccination in Italy in the reduction of the burden of RV‐related disease, estimating the relation between vaccination coverage and hospitalization rates. RVGE‐related hospitalizations that occurred in Italy from 2008 to 2018 among children aged 0−35 months were assessed by consulting the Hospital Discharge Record database and including records whose ICD‐9‐CM diagnosis code was 008.61 in the first or in any diagnosis position. In the 2008−2018 period, a total of 17 535 791 at‐risk person‐years were considered and 74 211 (423.2 cases × 100 000 per year) RVGE hospitalizations were observed. Higher hospitalization rates occurred in males (456.6 vs. 387.9 × 100 000 per year) and in children aged 1 year (507.8 × 100 000 per year). Poisson regression analysis showed a decrease of −1.25% in hospitalization rates (−1.19% to −1.31%, p < 0.001) per unit increase in vaccination coverage. This is the first study that correlates hospitalization rate reduction with a percentage increase in vaccination coverage. Our findings strongly support RV vaccination as an effective public health strategy for reducing RVGE‐related hospitalizations.