Pediatric Rotavirus Hospitalization Rates in the Military Health System Before and During the COVID-19 Pandemic

<b>Background/Objectives:</b> Rotavirus gastroenteritis is a vaccine-preventable disease that leads to hospitalization in children less than 5 years of age. Immunizations to prevent rotavirus have greatly altered the epidemiology of significant diarrheal illness. It has been reported that routine immunization rates in children were impacted during the COVID-19 pandemic. Contrary to this fact, rates of many childhood illnesses also decreased. <b>Methods:</b> The Military Health System Data Repository (MDR) contains the health records of all military beneficiaries. We queried the MDR before and during the COVID-19 pandemic to assess for alterations in immunization rates and hospitalization rates and to assess for risk factors for significant (hospitalizations) rotavirus disease. <b>Results:</b> Our study included a cohort of 1.27 million children under the age of 5 years old. There were 186 unique cases of rotavirus-related hospitalizations over the 5-year study period. During COVID-19 Years 1 and 2, there was a decrease in rotavirus-related hospitalizations compared to the pre-pandemic period. During Year 3, there was a return to the pre-pandemic level of rotavirus hospitalization rates. Patients in the northern United States were less likely to be hospitalized from rotavirus when compared to those in the south. The patients at greatest risk were the youngest beneficiaries. Rotavirus vaccination rates declined in this age group during all three years of the pandemic. <b>Conclusions:</b> As the pandemic resulted in less frequent rotavirus immunizations in the Military Health System (MHS), there was not an increase in rotavirus-related hospitalizations above the pre-pandemic baseline.