Sustained decline in rotavirus detections in the United States following the introduction of rotavirus vaccine in 2006.

BACKGROUND: Following implementation of the rotavirus vaccination program in 2006, rotavirus activity in the United States declined dramatically in 2007-2008 but increased slightly in 2008-2009, despite greater vaccine uptake. To further evaluate impact of the vaccine program, we assessed trends in rotavirus testing and detection during 2009-2010. METHODS: We examined rotavirus testing data from July 2000 to June 2010 from the National Respiratory and Enteric Viruses Surveillance System to compare rotavirus season timing and peak activity in the pre- and postvaccine introduction eras. Rotavirus season onset was defined as the first of 2 consecutive weeks during which the percentage of specimens testing positive for rotavirus was ≥ 10%. To assess trends in rotavirus testing and detection, we restricted the analyses to 25 laboratories that reported for ≥ 26 weeks per season from 2000 to 2010. RESULTS: During 2009-2010, the threshold for the start of the rotavirus season was never achieved nationally or in the North, Midwest, or West. Activity in the South met this threshold but the season duration was substantially shorter and of lower magnitude than in all previous pre- and postvaccine introduction seasons. Nationally and within each region, the peak week was more delayed and the peak proportion of positive tests was substantially lower than all previous seasons. The total number of tests performed declined by 23%, and the number of positive tests declined by 86%. CONCLUSIONS: Rotavirus activity was substantially diminished during the 2009-2010 rotavirus season compared with the prevaccine baseline and the 2 previous postvaccine introduction seasons. These sustained declines over 3 rotavirus seasons reaffirm the health benefits of the US rotavirus vaccination program.