Background. The coverage rate for rotavirus vaccine (RV) in the U.S., as assessed at 19 to 35 months of age, is lower than that for other vaccines, such as pneumococcal conjugate vaccine (PCV) and diphtheria, tetanus, and acellular pertussis vaccine (DTaP). RV differs from these other vaccines, however, in that administration at or beyond 8 months of age is not recommended. It is important to determine if the discrepancy in coverage rates arises during the first 6 months of life, when RV is being given along with DTaP and PCV, or if it arises after 8 months, when there is opportunity for catch-up dosing of DTaP and PCV but not for RV.
Methods. The MarketScan Commercial database was used to examine vaccination coverage for infants born between January 1, 2009 and May 31, 2012 and had at least 13 months of continuous enrollment in their respective health plans. Current Procedural Terminology (CPT) codes were used to identify vaccines administered as of milestone ages (3, 5, 7, 8, 10, and 13 months). Coverage was computed as the proportion of all infants eligible for vaccination according to the recommended schedule who had received the given vaccines. Coverage rates were stratified by variables such as gender and year of birth, among others.
Results. Of 392,160 eligible infants, coverage for the first dose at 3 months of age was 76%, 84% and 80% for RV, DTaP, and PCV respectively. At 7 months, coverage for the last dose of RV (dose 2 or 3, depending on product) and for 3 doses of DTaP and PCV, respectively, was 65%, 71% and 67%. At 13 months, the respective coverage rates were 69%, 81% and 82%. We observed an increase in coverage for each vaccine over the 4 study years, with the highest rate in 2012; in that year, coverage for all 3 vaccines was similar at 7 months of age, but differences were pronounced at 13 months of age (Table).
| Vaccine | Vaccine Coverage in 2012 | ||||
|---|---|---|---|---|---|
| 3 months | 5 months | 7 months | 8 months | 13 months | |
| RV | 80% | 75% | 69% | 73% | 73% |
| PCV | 82% | 76% | 69% | 75% | 84% |
| DTaP | 86% | 80% | 73% | 78% | 83% |
Note: Vaccine coverage is 1 dose at 3 months, 2 doses at 5 months and 3 doses (2 or 3 doses of RV) at 7, 8 and 13 months
Conclusion. Coverage for RV is similar to DTaP and PCV at milestone ages of 3, 5, and 7 months. The observation of higher coverage rates for DTaP and PCV at 13 months of age is probably due to catch-up opportunities for these vaccines but not for RV.
Disclosures. B. Gebremeskel, Merck and Co., Inc.: Post-doc fellow, Fellowship funded D. Zhang, Merck: Employee, Salary M. Goveia, Merck: Employee and Shareholder, Salary G. S. Marshall, Merck: Investigator, Research grant and Research support M. O'brien, Merck: Employee and Shareholder, Salary