Factors associated with rotavirus vaccine coverage
Copyright © 2019 by the American Academy of Pediatrics.
BACKGROUND: Rotavirus vaccines (RVVs) were included in the US immunization program in 2006 and are coadministered with the diphtheria-tetanus-acellular pertussis (DTaP) vaccine, yet their coverage lags behind DTaP. We assessed timing, initiation, and completion of the RVV series among children enrolled in active gastroenteritis surveillance at 7 US medical institutions during 2014–2016.
METHODS: We compared coverage and timing of each vaccine series and analyzed characteristics associated with RVV initiation and completion. We report odds ratios (ORs) and 95% confidence intervals (CIs) from multivariable logistic regression models.
RESULTS: We enrolled 10 603 children. In 2015, $1 dose coverage was 91% for RVV and 97% for DTaP. Seven percent of children received their first DTaP vaccine at age $15 weeks versus 4% for RVV (P # .001). Recent birth years (2013–2016) were associated with higher odds of RVV initiation (OR = 5.72; 95% CI 4.43–7.39), whereas preterm birth (OR = 0.32; 95% CI 0.24–0.41), older age at DTaP initiation (OR 0.85; 95% CI 0.80–0.91), income between $50 000 and $100 000 (OR = 0.56; 95% CI 0.40–0.78), and higher maternal education (OR = 0.52; 95% CI 0.36–0.74) were associated with lower odds. Once RVV was initiated, recent birth years (2013–2016; OR = 1.57 [95% CI 1.32–1.88]) and higher maternal education (OR = 1.31; 95% CI 1.07–1.60) were associated with higher odds of RVV completion, whereas preterm birth (OR = 0.76; 95% CI 0.62–0.94), African American race (OR = 0.82; 95% CI 0.70–0.97) and public or no insurance (OR = 0.75; 95% CI 0.60–0.93) were associated with lower odds. Regional differences existed.
CONCLUSIONS: RVV coverage remains lower than that for the DTaP vaccine. Timely DTaP administration may help improve RVV coverage.
Aliabadi, N., Wikswo, M. E., Tate, J. E., Cortese, M. M., Szilagyi, P. G., Staat, M., Weinberg, G. A., Halasa, N. B., Boom, J. A., Selvarangan, R., Englund, J. A., Azimi, P. H., Klein, E. J., Moffatt, M., Harrison, C. J., Sahni, L. C., Stewart, L. S., Bernstein, D. I., Parashar, U. D., Payne, D. C. Factors associated with rotavirus vaccine coverage Pediatrics 143, (2019).