Background: Rotavirus is a major cause of pediatric gastroenteritis worldwide, leading to severe health outcomes. Rotavirus vaccines (RV) have introduced grobally, in Japan, introduced in 2010 as self-payment and in 2020 as public funding vaccine. This study evaluates the change of gastroenteritis hospitalization and intussusception.
Methods: The descriptive study utilized JMDC claims database, focusing on 3 million children under 12 years from January 2005 to July 2023. The primary outcome was the incidence of all-cause gastroenteritis and rotavirus enteritis hospitalizations per 1000 person-year, with secondary outcomes including intussusception. Data were extracted using ICD-10 codes, and hospitalization rates were categorized into three periods: pre-vaccine (before October 2011), post-vaccine introduction (November 2011 to September 2020), and post-public funding (from October 2020). Statistical analyses included descriptive epidemiology, and interrupted time series (ITS) design.
Results: The study included 3,085,932 children (51 % male, 49 % female), with a mean age of 4.16 years. The gastroenteritis hospitalization per 1000 person-year under five year old age was 12.0 pre-vaccine period to 4.8 post-public funding period with a 60 % decrease (p < 0.001). Under the same conditions, hospitalization for rotavirus enteritis was 5.8 pre-vaccine period to 2.5 post-public funding period with a 58 % decrease (p < 0.01). ITS analysis showed a further -0.2 % monthly decrease in rotavirus enteritis hospitalizations post-vaccine introduction (p = 0.007). No significant changes were found for intussusception trends before and after RV.
Conclusion: In this study, gastroenteritis hospitalizations and rotavirus enteritis hospitalizations in children significant decreased. Intussusception rate were unchanged throughout the study period.
Keywords: Children; Epidemiology; Gastroenteritis; Intussusception; Rotavirus vaccine.
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