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National rotavirus vaccination programme implementation and gastroenteritis presentations: the paediatric emergency medicine perspective

  • John CoveneyEmail author
  • Michael Barrett
  • Patrick Fitzpatrick
  • Nandini Kandamany
  • Roisin Mcnamara
  • Stanley Koe
  • Ikechukwu Okafor
Original Article

Abstract

Background

Throughout the developed world, the introduction of rotavirus vaccination has led to reductions in the incidence and severity of acute gastroenteritis (AGE) in young children and consequently to reductions in paediatric emergency department (PED) attendances with AGE. Rotavirus vaccination was added to the Irish National Immunisation Schedule in November 2016.

Aims

To assess the impact of vaccine introduction on citywide PED attendances and hospital admissions with all-cause AGE during rotavirus season.

Methods

In an observational study, a retrospective search was performed of electronic records in three independent PEDs in Dublin. Weekly presentations and admissions with AGE in the first 30 weeks (gastroenteritis season) of the years 2012–2018 were counted and stratified by age.

Results

Median weekly presentations in 2017–2018, 126 (interquartile range (IQR) 103–165) were significantly lower than in 2012–2016, 160 (IQR 128–214) (p < 0.001). A reduction in presentations was seen across the three hospitals and in those aged less than 5 years. In one PED, median admissions in 2017–2018 were 10 (IQR 7–13) in comparison with nine (IQR 7–13) in 2012–2016, (p = 0.463). The emergency department AGE presentations to hospital ward admission rate was 6.7:1.

Conclusion

A reduction in PED presentations with AGE is demonstrated post-rotavirus vaccine introduction into the Irish National Immunisation Schedule. No significant change in paediatric hospital admissions was demonstrated.

Keywords

Acute gastroenteritis Paediatric emergency medicine Rotavirus Rotavirus vaccination 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Royal Academy of Medicine in Ireland 2019

Authors and Affiliations

  • John Coveney
    • 1
    Email author
  • Michael Barrett
    • 2
    • 3
    • 4
  • Patrick Fitzpatrick
    • 1
  • Nandini Kandamany
    • 1
  • Roisin Mcnamara
    • 1
  • Stanley Koe
    • 5
  • Ikechukwu Okafor
    • 1
  1. 1.Emergency DepartmentTemple Street Children’s University HospitalDublinIreland
  2. 2.Emergency DepartmentOur Lady’s Children’s Hospital CrumlinDublinIreland
  3. 3.Women’s & Children’s Health, School of MedicineUniversity College DublinDublinIreland
  4. 4.National Children’s Research CentreOur Lady’s Children’s HospitalDublin 12Ireland
  5. 5.Emergency Department, Incorporating the National Children’s HospitalTallaght University HospitalDublinIreland

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