The Impact of Rotavirus Implementation on Israeli Children: a Comparison between Pre- and Post-Vaccination Era

Objectives: Worldwide rotavirus vaccination has resulted in a substantial decrease in rotavirus-induced severe gastroenteritis and related hospitalizations among children. Still, the characterization of patients warranting hospitalization needs to be further elucidated.

Aim of the study: To compare the demographic clinical and laboratory features of children hospitalized with acute rotavirus infection in the pre-and post-rotavirus vaccine era.

Patients and methods: This is an observational, theoretical, retrospective study. The study included pediatric patients who presented to Bnai Zion Medical Center pediatric emergency department between 2009-2017 and diagnosed with rotavirus acute gastroenteritis.

Results: During the pre-vaccination period (2007-2009), 114 infants (median age 14 months, range 1-72 months; 59 male) were hospitalized for rotavirus–induced acute gastroenteritis with a rate of 13.41 positive rotavirus tests per 100 tests, while in the post-vaccination period (2012-2019), 168 cases of infants (median age 17 months, range 0-84 months; 90 male) with a rate of 9.38 positive rotavirus test per 100 tests. There were no statistical differences in gender, rate of breastfeeding and having sibling(s) between children. However, when comparing the degree of dehydration between the two groups, the proportion of cases with moderate-to-severe dehydration was higher in the post-vaccination children than in the pre-vaccinated children.

Conclusions: A decrease in the rate of rotavirus-attributed acute gastroenteritis hospitalizations when comparing the pre-and post-vaccination period. Higher proportions of dehydration were found in the post-vaccination children. Ongoing surveillance is warranted to better understand the implications of the vaccine.