Review of the health impact of the oral rotavirus vaccine program in children under 5 years in Australia: 2006 – 2021

• Published in: Vaccine Vol. 41; no. 3; pp. 636 - 648
• Main Authors: Middleton, Bianca F., Danchin, Margie, Fathima, Parveen, Bines, Julie E., Macartney, Kristine, Snelling, Thomas L.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 16-01-2023; Elsevier Limited
• Subjects: Aboriginal and Torres Strait Islander; Age; Australia; Australia - epidemiology; Child; Child, Preschool; Children; Effectiveness; Gastroenteritis; Gastroenteritis - epidemiology; Gastroenteritis - prevention & control; Hospitalization; Humans; Immunization; Impact; Infant; Intestinal obstruction; Jurisdiction; Licensed products; Licenses; Native peoples; Public Health; Reviews; Rotavirus; Rotavirus Infections - epidemiology; Rotavirus Infections - prevention & control; Rotavirus vaccine; Serotypes; Vaccine efficacy; Vaccines; Viruses; Australia; New South Wales Australia; Impact; Aboriginal and Torres Strait Islander; Rotavirus vaccine; Rotavirus; Australia
• ISSN: 0264-410X; 1873-2518
• DOI: 10.1016/j.vaccine.2022.12.008

Australian Rotavirus Vaccine Program•Achieved moderately high vaccine coverage rapidly.•Resulted in prompt reduction in rotavirus-coded hospitalisations for children < 5 years old.•High rates of rotavirus disease persist for Aboriginal and Torres Strait Islander children.•There was no difference in health impact for jurisdictions using Rotarix vs RotaTeq vaccine.
Oral rotavirus vaccines were incorporated into the National Immunisation Program (NIP) for all Australian infants in July 2007. Initially each of the eight jurisdictions implemented Rotarix or RotaTeq rotavirus vaccine, however from July 2017 all states and territories have administered Rotarix only. This review evaluates the health impact of the oral rotavirus vaccine program for Australian children less than 5 years old over the first 15 years of the rotavirus vaccine program, observing long-term changes in rotavirus-related health care attendances, public health notifications, and vaccine effectiveness and safety data for both Rotarix and RotaTeq rotavirus vaccines. We searched Medline for studies published between January 2006 and May 2022 using the search terms ‘rotavirus’, ‘rotavirus vaccine’ and ‘Australia’. Of 491 items identified, 76 items – 36 peer-reviewed articles and 40 reports – were included in the review. We found evidence that the introduction of the oral rotavirus vaccine program in Australia was associated with a prompt reduction in rotavirus-coded and all-cause gastroenteritis hospitalisations of vaccine-eligible children. In the context of less complete coverage, reduced vaccine timeliness and lower vaccine effectiveness, a less substantial and inconsistent reduction in severe rotavirus disease was observed among Aboriginal and Torres Strait Islander children, particularly those living in rural and remote northern Australia. Additional studies report no evidence for the emergence of non-vaccine serotypes and/ or replacement serotypes in Australia during the vaccine era. While the health impact for young children and consequent cost-savings of the oral rotavirus vaccine program have been high, it is important to find strategies to improve rotavirus vaccine impact for Aboriginal and Torres Strait Islander populations to ensure health benefits for all Australian children.