1858. Addressing Rotavirus Vaccination Missed Opportunities Using the National Immunization Survey
Session: Poster Abstract Session: Vaccines: Improving Immunization Uptake
Saturday, October 10, 2015
Room: Poster Hall
Background: In the United States, rotavirus vaccine (RV) coverage has plateaued below that of other infant vaccines. In 2013, the World Health Organization (WHO) expanded global recommendations for age at RV administration, but the US age restrictions remain unchanged. We assessed missed opportunities for RV series initiation and explored hypothetical increases in RV coverage if current age restrictions were expanded.

Methods: Data from the 2009 and 2012 National Immunization Survey (NIS) were analyzed to assess adherence to ACIP recommendations for RV. Administration of the first dose of RV from 6 weeks (wks) – <15 weeks was considered ACIP adherent. We considered administration of diphtheria, tetanus, and acellular pertussis vaccine (DTaP) as a potential marker of an opportunity for RV administration. Additionally, we calculated the hypothetical increase in RV coverage if current RV age restrictions were expanded, accounting for potential missed opportunities outside the current RV administration window

Results: Of 17,053 children in the 19-35 month 2012 NIS cohort, only 83% received at least 1 dose of RV. Of these children, 95% received RV within the ACIP recommended timeframe.  Of those that did not receive RV, 85% received >= 1 dose of DTaP of which 68% was administered within the current ACIP RV recommendations (6 - <15 wks).  If RV were administered at DTaP opportunities beyond current ACIP RV recommendations, then an additional  5%, or 269,182 children, would have started the series.   If RV were administered to all children with missed opportunity for RV administration, an additional 14%, or 845,894 children ages 19-35 mo would have received >= 1 dose RV in the 2012 cohort, resulting in 97% initiation.

Conclusion: Addressing missed opportunities and expanding the recommendations for RV administration could increase RV initiation to vaccination levels observed with other infant vaccines and potentially provide direct and indirect protection to additional children and adults.

Monica Lachey, MPH, Rollins School of Public Health, Emory University, Atlanta, GA, Robert Bednarczyk, PhD, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, Evan J. Anderson, MD, Atlanta Veterans Affairs Medical Center, Atlanta, GA and Walter A. Orenstein, MD, FIDSA, FPIDS, Medicine, Emory University, Atlanta, GA


M. Lachey, None

R. Bednarczyk, None

E. J. Anderson, Abbvie: Consultant , Consulting fee
MedImmune: Investigator , Research grant
Roche: Editorial assistance in writing a manuscript , Editorial assistance in writing a manuscript

W. A. Orenstein, None

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