Children are spending less time in the hospital with inflammation of the stomach, thanks to a rotavirus vaccine.

A study published today in the latest issue of The Journal of the American Medical Association reports that hospitalization rates for acute gastroenteritis among U.S. children younger than 5 years of age has declined by 31 percent to 55 percent in each of the years between 2008 and 2012, following the implementation of the vaccine in 2006.

For their study, Dr. Eyal Leshem of the U.S. Centers for Disease Control and Prevention and his colleagues examined all causes of gastroenteritis and rotavirus-related hospitalizations among children younger than 5 years from 2000 through 2012. 

The researchers analyzed State Inpatient Databases of the Healthcare Cost and Utilization Project, which include hospitalizations in community and academic hospitals. The analyses were restricted to 26 states. About 74 percent of U.S. children younger than 5 years live in these states. 

Rotavirus is a major cause of severe diarrhea among infants and young children. Before the vaccine was introduced in 2006, rotavirus was responsible for about 400,000 visits to doctors’ offices, 200,000 emergency room visits, 55,000 to 70,000 hospitalizations, and 20 to 60 deaths each year among children under 5 years in the U.S., Leshem said. Globally, rotavirus causes close to half a million deaths each year in young children. 

Seasonal peaks in hospitalization for diarrhea due to rotavirus substantially diminished once the vaccination became available, said Leshem. He explained that the decrease magnifies the importance of efforts to increase vaccination rates.

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More Than a Million Cases Examined

The analyses included 1,201,458 all-cause acute gastroenteritis hospitalizations among U.S. children younger than 5 years from 2000 through 2012. Of those, 199,812 were assigned a rotavirus-specific code.

The researchers found that compared with the pre-vaccine average annual acute gastroenteritis hospitalization rate of 76 per 10,000 young children, the post-vaccine introduction rates declined by 31 percent in 2008, 33 percent in 2009, 48 percent in 2010, 47 percent in 2011, and 55 percent in 2012.

Similar rate declines were noted in both boys and girls as well as in all ethnicities and all age groups. The greatest decreases were among children age 6 months to 23 months. 

Compared with the pre-vaccine average annual rotavirus-coded hospitalization rate of 16 per 10,000 young children, rates of rotavirus-coded hospitalizations post-vaccine introduction declined by 70 percent in 2008, 63 percent in 2009, 90 percent in 2010, 79 percent in 2011, and 94 percent in 2012. 

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Coverage, Herd Immunity Helping Reduce Illnesses

By 2012, the declines were noticed in all settings and age groups. This appears to be the result of increasing vaccine coverage as well as herd immunity, said Leshem.

By 2012, children 48 to 59 months of age were eligible for the vaccine. During that year the estimated rotavirus vaccination coverage among children 19 to 35 months of age reached 69 percent. 

“With an increase in vaccine coverage, herd protection may have contributed to larger declines in rotavirus hospitalizations. In 2012, when vaccine coverage was highest, the greatest reductions were observed for all causes of acute gastroenteritis and rotavirus-coded hospitalizations,” the authors wrote. 

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