Trends in rate of seizure-associated hospitalizations among children <5 years old before and after rotavirus vaccine introduction in the United Sates, 2000-2013

Kimberly D. Pringle, Rachel M. Burke, Claudia Angelica Steiner, Umesh D. Parashar, Jacqueline E. Tate

Research output: Contribution to journalArticle

Abstract

Background. Rotavirus is a common cause of acute gastroenteritis and has also been associated with generalized tonic-clonic afebrile seizures. Since rotavirus vaccine introduction, hospitalizations for treatment of acute gastroenteritis have decreased. We assess whether there has been an associated decrease in seizure-associated hospitalizations. Methods. We used discharge codes to abstract data on seizure hospitalizations among children <5 years old from the State Inpatient Databases of the Healthcare Cost and Utilization Project. We compared seizure hospitalization rates before and after vaccine introduction, using Poisson regression, stratifying by age and by month and year of admission. We performed a time-series analysis with negative binomial models, constructed using prevaccine data from 2000 to 2006 and controlling for admission month and year. Results. We examined 962 899 seizure hospitalizations among children <5 years old during 2000-2013. Seizure rates after vaccine introduction were lower than those before vaccine introduction by 1%-8%, and rate ratios decreased over time. Time-series analyses demonstrated a decrease in the number of seizure-coded hospitalizations in 2012 and 2013, with notable decreases in children 12-17 months and 18-23 months. Conclusions. Our analysis provides evidence for a decrease in seizure hospitalizations following rotavirus vaccine introduction in the United States, with the greatest impact in age groups with a high rotavirus-associated disease burden and during rotavirus infection season.

Original languageEnglish (US)
Pages (from-to)581-588
Number of pages8
JournalJournal of Infectious Diseases
Volume217
Issue number4
DOIs
StatePublished - Feb 15 2018
Externally publishedYes

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Rotavirus Vaccines
Seizures
Hospitalization
Vaccines
Rotavirus
Gastroenteritis
Rotavirus Infections
Statistical Models
Health Care Costs
Inpatients
Age Groups
Databases

Keywords

  • Rotavirus
  • Seizures
  • Vaccine

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

Cite this

Trends in rate of seizure-associated hospitalizations among children <5 years old before and after rotavirus vaccine introduction in the United Sates, 2000-2013. / Pringle, Kimberly D.; Burke, Rachel M.; Steiner, Claudia Angelica; Parashar, Umesh D.; Tate, Jacqueline E.

In: Journal of Infectious Diseases, Vol. 217, No. 4, 15.02.2018, p. 581-588.

Research output: Contribution to journalArticle

Pringle, Kimberly D. ; Burke, Rachel M. ; Steiner, Claudia Angelica ; Parashar, Umesh D. ; Tate, Jacqueline E. / Trends in rate of seizure-associated hospitalizations among children <5 years old before and after rotavirus vaccine introduction in the United Sates, 2000-2013. In: Journal of Infectious Diseases. 2018 ; Vol. 217, No. 4. pp. 581-588.
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abstract = "Background. Rotavirus is a common cause of acute gastroenteritis and has also been associated with generalized tonic-clonic afebrile seizures. Since rotavirus vaccine introduction, hospitalizations for treatment of acute gastroenteritis have decreased. We assess whether there has been an associated decrease in seizure-associated hospitalizations. Methods. We used discharge codes to abstract data on seizure hospitalizations among children <5 years old from the State Inpatient Databases of the Healthcare Cost and Utilization Project. We compared seizure hospitalization rates before and after vaccine introduction, using Poisson regression, stratifying by age and by month and year of admission. We performed a time-series analysis with negative binomial models, constructed using prevaccine data from 2000 to 2006 and controlling for admission month and year. Results. We examined 962 899 seizure hospitalizations among children <5 years old during 2000-2013. Seizure rates after vaccine introduction were lower than those before vaccine introduction by 1{\%}-8{\%}, and rate ratios decreased over time. Time-series analyses demonstrated a decrease in the number of seizure-coded hospitalizations in 2012 and 2013, with notable decreases in children 12-17 months and 18-23 months. Conclusions. Our analysis provides evidence for a decrease in seizure hospitalizations following rotavirus vaccine introduction in the United States, with the greatest impact in age groups with a high rotavirus-associated disease burden and during rotavirus infection season.",
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