VACCINE RESOURCE COMMITTEE

of the Edmonton Zone Medical Staff Association

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Rotavirus Vaccine Question #1:

Why is the vaccine better than getting diarrhea?

Rotavirus is the most common cause of diarrhea and hospitalization for diarrhea in children under 5 years of age. Almost all unimmunized children will have at least 1 rotavirus infection before they turn 5.

Rotavirus is a common cause of gastroenteritis in children; approximately 36% of children with RV gastroenteritis see a physician, 15% visit an emergency department, and 7% require hospitalization. Rotavirus is the most common cause of diarrhea and hospitalization for diarrhea in children under 5 years of age.

RV vaccine efficacy against diarrhea of any severity in developed world settings is 74% to 87%; efficacy against severe diarrhea is 85% to 98%. Before a vaccine was available, many children who became ill with rotavirus were hospitalized.

An immunized child protects others as well. People who are immunized are much less likely to catch a preventable disease and spread it to others.

Immunocompromised children are at an increased risk of severe, prolonged and even fatal gastroenteritis. Among adults, RV infection causes gastroenteritis primarily in travelers returning from developing countries, parents and persons caring for children with RV gastroenteritis, immunocompromised persons, and older adults. Outbreaks of RV gastroenteritis, associated with considerable morbidity, have been reported in long-term care facilities.

RV infections are extremely common worldwide. By 5 years of age, most children will have experienced at least one RV infection. This occurrence is true in both developed and developing countries, suggesting that improved sanitation does not decrease RV transmission. However, mortality due to RV infection is much higher in developing countries. The World Health Organization (WHO) estimates that 453,000 children aged less than 5 years died in 2008 from vaccine-preventable RV infections; most of these children lived in low income countries. Globally, these 453,000 childhood RV deaths account for approximately 5% of all childhood deaths.

In Canada, RV is a common cause of gastroenteritis in children, accounting for 10% to 40% of all childhood gastroenteritis. Based upon Canadian data, although death is extremely rare, RV infection is associated with considerable indirect costs and time for patients and their families. Approximately 36% of children with RV gastroenteritis see a physician, 15% visit an emergency department, and 7% require hospitalization. RV causes the majority of childhood gastroenteritis requiring hospitalization; between 1 in 62 to 1 in 312 children less than 5 years of age will require hospitalization for RV. Parents of children with RV gastroenteritis are more likely than parents of children with other gastroenteritis to miss work, and out-of-pocket costs are considerable for families of affected children, even for cases of low severity. 

Sources:

Health Link BC: Rotavirus vaccine (Rotarix®)
Government of Canada: Rotavirus vaccines: Canadian Immunization Guide