Sharp fall in GP visits for acute gastroenteritis after rotavirus vaccination introduction

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The study, led by the London School of Hygiene & Tropical Medicine with Public Health England, found that the fall in visits was biggest among young children (the age group that receives the rotavirus vaccination), but there was also a decrease in visits by older children and adults. This suggests herd immunity from the vaccination programme; individuals were protected even if unvaccinated due to the decrease in circulating rotavirus.

Rotavirus is highly infectious and is the commonest cause of acute gastroenteritis in young children, causing diarrhoea, vomiting and fever. Infection with rotavirus results in considerable use of health services in the UK.

The UK-wide rotavirus vaccination programme was introduced in 2013. The vaccine is given as oral drops in two doses, to babies aged between two and three months old.

Previous research has shown that the introduction of the programme has resulted in a decrease in hospitalisations and Emergency Department visits for acute gastroenteritis among adults and children.

The new study used primary care data to look at the impact on GP visits and went on to estimate the visits and healthcare costs averted in England across all healthcare settings.

In GP surgeries, rates of acute gastroenteritis in young children fell by 15% overall after the vaccine introduction, and by 41% in the months where rotavirus circulation was historically high. Rates also decreased in older children and to a lesser degree in adults.

The researchers went on to estimate that across GPs, hospital admissions and Emergency Departments, 87,376 visits by children under five were averted in the first year of the vaccination programme. This was associated with an estimated £12.5 million reduction in healthcare costs.

Lead author Dr Sara Thomas from the London School of Hygiene & Tropical Medicine, said: "This study helps to give a more complete picture of the impact of rotavirus vaccination, and shows the rapid reduction in the burden of acute gastroenteritis seen in GP surgeries.

"We found that the expected seasonal peak of acute gastroenteritis in the months when rates historically would have been high completely disappeared. The fact that GP visits for gastroenteritis in other age groups fell provides evidence that unvaccinated older individuals are also benefitting from the vaccine being introduced.

"Our new estimates of the tens of thousands of health service visits by young children that have been averted, with a reduction in annual healthcare costs of more than £12 million, also provide important information for assessing the overall benefits of introducing the vaccine."

Study co-author Dr Shamez Ladhani, Immunisation Consultant at Public Health England, said: "This is good news and it is reassuring that the rotavirus vaccine is preventing so many cases of vomiting and diarrhoea since it was introduced three years ago. This is thanks to the high vaccine uptake in infants, which has also helped to protect older unvaccinated children and adults of all ages across the UK. It is also further evidence that our UK Immunisation programme is playing a vital role in protecting the public's health."

Nicola Blackwood, the Minister for Public Health and Innovation said: "This research shows the overwhelming public health benefit of giving young children the rotavirus vaccination. This vaccine is keeping children safe whilst freeing up more of doctors' and nurses' time and saving money for the NHS."

The authors say that one potential limitation of the study is that the decrease in acute gastroenteritis observed could be due to factors other than the introduction of the vaccine. Analyses are now underway to compare rates of acute gastroenteritis in vaccinated and unvaccinated infants, to obtain direct estimates of the effectiveness of the vaccine.

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The study was funded by the National Institute for Health Research (NIHR) Health Protection Research Unit in Immunisation at the London School of Hygiene & Tropical Medicine in partnership with Public Health England.

For more information, please contact the London School of Hygiene & Tropical Medicine press office on [email protected] / +44(0)2079272802.

Copies of this paper are available to credentialed journalists upon request; please contact Elsevier's Newsroom at [email protected] or +31 20 485 2492.

Notes to Editors:

  • Sara L Thomas, Jemma L Walker, Justin Fenty, Katherine E Atkins, Alex J Elliot, Helen E Hughes, Julia Stowe, Shamez Ladhani, Nick J Andrews, Impact of the national rotavirus vaccination programme on acute gastroenteritis in England and associated costs averted. Vaccine. DOI: 10.1016/j.vaccine.2016.11.057

About the London School of Hygiene & Tropical Medicine

The London School of Hygiene & Tropical Medicine is a world-leading centre for research and postgraduate education in public and global health, with more than 4,000 students and 1,000 staff working in over 100 countries. The School is one of the highest-rated research institutions in the UK, is among the world's leading schools in public and global health, and was named University of the Year in the Times Higher Education Awards 2016. Our mission is to improve health and health equity in the UK and worldwide; working in partnership to achieve excellence in public and global health research, education and translation of knowledge into policy and practice. http://www.lshtm.ac.uk

The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. The NIHR is the research arm of the NHS. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government's strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website (http://www.nihr.ac.uk).

About Vaccine

Vaccine is the pre-eminent journal for those interested in vaccines and vaccination. It is the official journal of The Edward Jenner Society and The Japanese Society for Vaccinology and is published by Elsevier http://www.elsevier.com/locate/vaccine

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