Using Medical Claims Data for Timely Estimation of Rotavirus Vaccine Coverage

Background: The rotavirus vaccine RotaTeq® was recommended for US infants in Feb’06. while Rotarix® use began in August 2008. CDCs National Immunization Survey (NIS) is used to estimate national vaccine coverage, but such data lag by several years.  We estimated Rotavirus coverage using a stable sub-sample of SDIs ~40% national sample of all physician’s office medical claims data available with less than 1 month delay. Our strategy addressed the key challenge that Vaccine for Children (VFC) doses may not be claimed.

Objectives: To demonstrate the utilization of SDIs large medical claims database to track vaccine coverage of novel pediatric vaccines in near-real time

Methods: SDI captures electronic healthcare reimbursement claims submitted from ~300,000 (~45%) of all US physicians’ offices with 1-2 weeks lag.  Using a synthetic ID, individual visit data were converted to longitudinal patient-level data.  We recorded CPT codes for Rotateq, Ritarix and DTaP and recorded the date, and age at each claimed vaccine dose at each baby well visit. We then computed Rotateq coverage relative to the observed DTaP coverage.  Then, using NIS DTaP dose coverage estimates we proportionally generated Rotateq 1+ coverage estimate.

Results: In the 2006-07 season, a moderate rotavirus vaccine coverage level had been achieved only in infants <12mo (while older infants were too old at the time the rotavirus vaccination program began).  By the 2007-08 Rotavirus season, moderate-high levels (40-60% coverage) had been achieved in age cohorts up to 18 mo.  By the 2008-09 season, a coverage level of almost 80% had been achieved in infants aged up to 24 mo. In March’09, RotaTeq® accounted for 85% of all 1^st doses of Rotavirus vaccine administered

Conclusions:  We have demonstrated that timely national coverage estimates needed for timely evaluation of vaccine program benefits can be generated using medical claims data and an age cohort analysis strategy.  This novel method can be used to study national and regional patterns of coverage of novel pediatric vaccines.  Our Rotavirus vaccine coverage estimates will be validated against NIS data as these become available.