Peer-reviewed article
Rotavirus Vaccine Coverage and Potential Barriers Among US Children Born From 2007 to 2024.
Mary C Moran, Mary E Wikswo, Leila C Sahni, Julie A Boom, Rangaraj Selvarangan et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined rotavirus vaccine coverage and barriers to vaccination among US children born between 2007 and 2024. Researchers found that current vaccine guidelines, which restrict rotavirus vaccination to before 15 weeks of age and prohibit administration in neonatal intensive care units, create significant barriers to immunisation. The strongest risk factors for not receiving the vaccine included delayed administration of other routine vaccines, extremely preterm birth, and lack of health insurance. The study suggests that revising guidelines to allow vaccination in neonatal units could improve coverage rates.
Key points
- 24,755 children were included in the analysis, examining vaccination status and barriers
- Receiving the diphtheria, tetanus, and pertussis vaccine at or after 15 weeks was the strongest predictor of not initiating rotavirus vaccine (OR 30.0)
- Extremely preterm infants had 14.6 times higher odds of not receiving rotavirus vaccine, with over 50% still in NICU at age 15 weeks or older
- Lack of health insurance increased the odds of not initiating the vaccine by 2.2 times
- Children born soon after rotavirus vaccine introduction (2007-2009) were 3.3 times more likely to not initiate the series
Limitations
The study is observational and cannot establish causation. It does not examine vaccine acceptance or parental hesitancy, focusing only on structural and timing barriers to immunisation.
Abstract
BACKGROUND/OBJECTIVES: The Advisory Committee on Immunization Practices recommends the first dose of rotavirus vaccine (RVV) be delivered by a maximum age of 14 weeks, 6 days and that the vaccine not be delivered until time of discharge from the neonatal intensive care unit (NICU). We hypothesized that these guidelines limit the number of children who can be vaccinated with RVV. METHODS: Children born on or after January 1, 2007, enrolled in the New Vaccine Surveillance Network from December 2014 to August 2024 aged at least 15 weeks with rotavirus-negative acute gastroenteritis or as a healthy control, and with known vaccination status were included. We identified factors associated with not initiating or completing the RVV series and missed opportunities for vaccination. Odds ratios (ORs) and 95% CIs were calculated using univariate logistic regression. RESULTS: A total of 24 755 children met the inclusion criteria. The risk factors most strongly associated with not initiating RVV were receiving the diphtheria, tetanus, and pertussis vaccine at greater than or equal to age 15 weeks (OR, 30.0; 95% CI, 26.8-33.7), extremely preterm birth (OR, 14.6; 95% CI, 11.2-20.0), being born soon after RVV introduction (2007-2009) (OR, 3.3; 95% CI, 2.9-3.8), and having no health insurance (OR, 2.2; 95% CI, 1.8-2.7). More than 50% of extremely preterm infants in the NICU were not discharged until greater than or equal to age 15 weeks. CONCLUSIONS: Re-evaluation of the vaccine guidelines to allow RVV administration in the NICU may remove barriers to vaccination and help improve RVV coverage.