Josephine van Dongen

Chapter 7 170 Table 4. Parental experience with the targeted rotavirus vaccination program Statement Vaccinated infants (N=194) Unvaccinated infants (N=19) p-value The information provided to me about rotavirus vaccination was clear (n agree with statement, %) 159/174 (91.4) 14/17 (82.4) 0.22 I was first informed about rotavirus vaccination by a pediatric doctor/ nurse (n agree with statement, %) 59/173 (34.1) 5/13 (38.5) 0.83 I received timely information; I had sufficient time to decide whether I wanted to vaccinate my child (n agree with statement, %) 139/173 (80.3) 8/16 (50.0) 0.01 Rotavirus vaccination should be available for all children (n, %) 94/171 (55.0) 9/13 (69.2) 0.32 Percentages are derived excluding respondents with missing information. Statistical significance (p-value <0.05) is highlighted in bold. Discussion This study evaluated the implementation of a targeted rotavirus vaccination program for infants with MRC in secondary and ter tiary care. This strategy resulted in 52.3% of eligible infants receiving at least one dose of HRV (with a wide variety in coverage among sites and infants from different risk-groups). Less than 40% of parents were informed about the vaccine as par t of standard care and reaching these vulnerable infants proved difficult. If vaccinated, however, timely vaccination was feasible for over 90% of these medical risk infants. A targeted vaccine strategy is rare, only Croatia implemented a risk-group rotavirus vaccination program in 2011 21 and Spain introduced rotavirus vaccination for premature babies between 25 and 32 weeks of GA. 22 Arguments for a targeted vaccine strategy are to protect those at highest risk of severe disease, mor tality and complications 16. Vaccination coverage is known to be lower among premature infants <33 weeks of GA and LBW infants 23 , as was also observed for rotavirus vaccination 24 .Yet, this was studied in a setting with universal rotavirus vaccination. Whether a targeted vaccination program was feasible in practice with sufficient coverage among these risk-group infants was not systematically assessed. This implementation study indicates that a targeted rotavirus vaccination strategy for infants