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Canadian Journal of Public Health

, Volume 107, Issue 2, pp e161–e167 | Cite as

Trends in severe gastroenteritis among young children according to socio-economic characteristics before and after implementation of a rotavirus vaccination program in Quebec

  • Virginie Gosselin
  • Geneviève Petit
  • Arnaud Gagneur
  • Mélissa GénéreuxEmail author
Quantitative Research

Abstract

OBJECTIVES: Following implementation of a publicly funded rotavirus immunization program in Quebec (Canada) in 2011, its impact on gastroenteritis hospitalization rates, a proxy for severe gastroenteritis, was assessed.

METHODS: Using a tertiary hospital database and a regional vaccination registry, temporal trends in rates of hospitalization for acute gastroenteritis (AGE) and rotavirus gastroenteritis before the age of five years and rotavirus vaccine coverage were examined from June 2004 through May 2014 in a large retrospective birth cohort in the Eastern Townships region. The mean annual AGE hospitalization rate in post-program years (2011/2012–2013/2014) was compared with that in pre-program years (2004/2005–2010/2011) overall and according to the characteristics of the children, families and residential neighbourhoods at birth.

RESULTS: The AGE hospitalization rate significantly decreased from 81/10,000 in the pre-program period to 46/10,000 in the post-program period (relative reduction = 43%). Following implementation of the program, vaccine coverage rapidly increased and reached 81 %. All socio-economic categories showed a reduced hospitalization rate in the post-program period, but the lowest relative reductions were observed in children living in neighbourhoods with higher rates of unemployment, low-income families and single mothers. However, these disadvantaged subgroups did not have lower vaccine coverage.

CONCLUSIONS: Three years following its introduction in a universal vaccination program, rotavirus vaccine significantly reduced severe gastroenteritis in young children. Despite similar vaccine coverage among all children, disadvantaged socio-economic groups appeared to have a less pronounced AGE reduction, suggesting that factors other than vaccination could partially influence the reduction of gastroenteritis morbidity in young children.

Key words

Rotavirus infections rotavirus vaccines immunization programs gastroenteritis child socio-economic 

Résumé

OBJECTIFS: Suite à l’implantation d’un programme de vaccination contre le rotavirus financé publiquement au Québec en 2011, son impact sur les taux d’hospitalisation pour gastro-entérite, un proxy pour les gastroentérites sévères, a été évalué.

MÉTHODES: Grâce à l’utilisation d’une base de données hospitalières et d’un registre de vaccination régional, les tendances temporelles des taux d’hospitalisation pour gastro-entérite aiguë (GEA) et gastro-entérite à rotavirus (GERV) survenues avant l’âge de cinq ans ainsi que la couverture vaccinale ont été examinées de juin 2004 à mai 2014 parmi une large cohorte rétrospective d’enfants nés dans la région de l’Estrie. Le taux annuel moyen d’hospitalisation pour GEA des années post-programme (2011/2012–2013/2014) a été comparé à celui des années pré-programme (2004/2005–2010/2011 ), globalement et selon plusieurs caractéristiques de l’enfant, de sa famille et de son quartier résidentiel à la naissance.

RÉSULTATS: Le taux d’hospitalisation pour GEA a diminué de 81 /10 000 dans la période pré-programme à 46/10 000 dans la période post-programme (réduction relative = 43 %). Suite à l’implantation du programme, la couverture vaccinale a rapidement augmenté et a atteint 81 %. Toutes les catégories socioéconomiques ont démontré un taux d’hospitalisation réduit dans la période postprogramme, néanmoins les plus faibles réductions relatives ont été observées chez les enfants vivant dans des quartiers ayant des taux élevés d’inemploi, de familles à faible revenu et de mères vivant seules. Cependant, ces sous-groupes défavorisés ne présentaient pas une couverture vaccinale plus faible.

CONCLUSIONS: Trois ans après son introduction dans un programme de vaccination universel, le vaccin contre le rotavirus a significativement réduit les gastro-entérites sévères chez les jeunes enfants. Malgré une couverture vaccinale similaire parmi tous les enfants, les groupes socioéconomiquement défavorisés semblent avoir connu une réduction moins prononcée des GEA, suggérant que des facteurs autre que la vaccination peuvent partiellement influencer la réduction de la morbidité reliée à la gastro-entérite chez les jeunes enfants.

Mots clés

infections à rotavirus vaccins contre le rotavirus programmes d’immunisation gastro-entérite enfant socioéconomique 

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Copyright information

© The Canadian Public Health Association 1996

Authors and Affiliations

  • Virginie Gosselin
    • 1
  • Geneviève Petit
    • 1
    • 2
  • Arnaud Gagneur
    • 3
  • Mélissa Généreux
    • 1
    Email author
  1. 1.Community Health Sciences Department, Faculty of Medicine and Health SciencesUniversity of SherbrookeSherbrookeCanada
  2. 2.Eastern Townships Public Health DepartmentCIUSSS de l’Estrie-CHUSSherbrookeCanada
  3. 3.Pediatrics Department, Faculty of Medicine and Health SciencesUniversity of SherbrookeSherbrookeCanada

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