190946 Rotavirus Vaccination Uptake and Compliance among Managed Care Infants in the United States (US)

Sunday, October 26, 2008

Ami R. Sklar, MPH , Health Economics and Outcomes, i3 Innovus, Eden Prairie, MN
Jason E. Kemner, MPH , US Health Outcomes, GlaxoSmithKline, Philadelphia, PA
Henry J. Henk, PhD , Health Economics and Outcomes, i3 Innovus, Eden Prairie, MN
Background: Rotavirus is the leading cause of gastroenteritis in infants and young children, causing significant morbidity and mortality worldwide. As of April 2008, two rotavirus vaccines have been approved by the US Food and Drug Administration (FDA). The US Advisory Committee on Immunization Practices (ACIP) recommends vaccination for all infants. Our study examines vaccination uptake, schedule compliance and series completion of rotavirus vaccine among infants in a large US managed care plan.

Methods: Infants born 01/2006-06/2007 with commercial or Medicaid coverage and 15 weeks continuous health plan enrollment following birth were identified to evaluate vaccination uptake. A subpopulation of infants born 11/2006-02/2007 and enrolled for 8 months, were identified to evaluate series completion and compliance to the ACIP recommended vaccination schedule.

Results: Overall, 170,329 infants with 15 weeks enrollment were born 01/2006-06/2007 (~10,000/month). Rotavirus vaccination initiation rates rose from <1% among infants born 01/2006, to 63% among infants born 06/2007. Among the subpopulation born 11/2006-02/2007 with 8 months enrollment (n=29,717), 59% initiated rotavirus vaccination; 54% initiated on-time (by age <15 weeks). By age 8 months, just 43% had completed the full series. Among infants initiating on-time, 95% received a second dose and 79% completed the series.

Discussion: Rotavirus vaccination on-time completion rates remained well below 50%. Among infants who initiated vaccination, on-time completion rates improved. Strategies that focus on increasing vaccination uptake should have a positive impact on completion rates overall. Vaccines with more flexible schedules or fewer doses may also impact completion rates.

Learning Objectives:
1. Describe the new ACIP rotavirus vaccination recommendations 2. Assess current rotavirus vaccination initiation and completion rates among infants in the US 3. Discuss strategies for improving rotavirus vaccination coverage levels

Keywords: Immunizations, Rotavirus

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a Senior Researcher specializing in epidemiologic methods and analysis at i3 Innovus. For this research, I was responsible for overall project management, including research design and protocol development, oversight of dataset construction, data analysis, and coordination of research dissemination. I have experience designing and conducting epidemiologic studies; and collecting, managing and analyzing data from a variety of sources including: healthcare claims, public health surveillance, and survey data. Prior to joining i3 Innovus, I received my MPH in Epidemiology from the University of Minnesota and worked for more than 7 years as a public health epidemiologist at local and state public health agencies; and at the Centers for Disease Control and Prevention where I completed an ASPH fellowship at the National Immunization Program.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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