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1
On January 5, 2026, the CDC replaced routine rotavirus vaccination recommendations with shared clinical decision-making; a federal judge temporarily reinstated routine vaccination on March 16.
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A decision analytical model assessed 10%, 20%, and 30% shifts from fully vaccinated to unvaccinated infants under shared clinical decision-making.
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At current uptake, the model estimated more than 20,200 rotavirus-related hospitalizations and 126,800 emergency department visits among US infants by age 2 years per annual birth cohort.
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A 10% to 30% shift to unvaccinated status was projected to add 1,500 to 4,500 hospitalizations, 4,400 to 13,200 emergency department visits, and $34.5 million to $103.5 million in expenditures.
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Projections excluded indirect protection, outpatient visits, and children aged 2 years or older, and may underestimate acute gastroenteritis burden because of low coding sensitivity.
