Factors Associated With Rotavirus Vaccine Coverage

BACKGROUND: Rotavirus vaccines (RVVs) were included in the US immunization program in 2006 and are coadministered with the diphtheria-tetanus-acellular pertussis (DTaP) vaccine, yet their coverage lags behind DTaP. We assessed timing, initiation, and completion of the RVV series among children enrolled in active gastroenteritis surveillance at 7 US medical institutions during 2014–2016. METHODS: We compared coverage and timing of each vaccine series and analyzed characteristics associated with RVV initiation and completion. We report odds ratios (ORs) and 95% confidence intervals (CIs) from multivariable logistic regression models. RESULTS: We enrolled 10 603 children. In 2015, ≥1 dose coverage was 91% for RVV and 97% for DTaP. Seven percent of children received their first DTaP vaccine at age ≥15 weeks versus 4% for RVV (P ≤ .001). Recent birth years (2013–2016) were associated with higher odds of RVV initiation (OR = 5.72; 95% CI 4.43–7.39), whereas preterm birth (OR = 0.32; 95% CI 0.24–0.41), older age at DTaP initiation (OR 0.85; 95% CI 0.80–0.91), income between $50 000 and $100 000 (OR = 0.56; 95% CI 0.40–0.78), and higher maternal education (OR = 0.52; 95% CI 0.36–0.74) were associated with lower odds. Once RVV was initiated, recent birth years (2013–2016; OR = 1.57 [95% CI 1.32–1.88]) and higher maternal education (OR = 1.31; 95% CI 1.07–1.60) were associated with higher odds of RVV completion, whereas preterm birth (OR = 0.76; 95% CI 0.62–0.94), African American race (OR = 0.82; 95% CI 0.70–0.97) and public or no insurance (OR = 0.75; 95% CI 0.60–0.93) were associated with lower odds. Regional differences existed. CONCLUSIONS: RVV coverage remains lower than that for the DTaP vaccine. Timely DTaP administration may help improve RVV coverage.