Low uptake rotavirus vaccineMrzel, Maja (Avtor) Danis, Kostas (Avtor) Učakar, Veronika (Avtor) electronic health recordshospitalizationnational vaccination programmevaccinationBackground In Slovenia, coverage of rotavirus vaccines (Rotarix (RV1) and RotaTeq (RV5)) remains low, and the vaccines are not included in the National Vaccination Programme (NVP). We aimed to estimate vaccine effectiveness (VE) against rotavirus-related hospitalization among children aged 6 weeks to 5 years to inform national vaccination policy. Methods We linked Slovenian population registry with vaccination, surveillance, and hospitalization databases for 2019–2023 birth cohorts. We defined fully vaccinated as those receiving all recommended doses with the last dose ≥14 days before the end date (disease onset or hospitalization date, death, or study end) and partially vaccinated those receiving ≥1 dose ≥14 days before the end date. We estimated VE using quasi-Poisson regression, adjusting for age, healthcare access, socioeconomic status, and calendar time, with person-time at risk included as an offset. We also examined the relationship between full vaccination coverage and hospitalization rates across municipalities using Pearson's correlation coefficient. Results Among 89,994 children, 4% were partially, and 25% fully vaccinated. A total of 1272 rotavirus hospitalizations occurred, 94% among unvaccinated children. VE against hospitalization was 84% (95% CI: 73%–91%) for full and 81% (95% CI: 42%–94%) for partial vaccination. VE was 85% (95% CI: 74%–91%) for RV1 and 78% (95% CI: −29%–96%) for RV5. VE was 73% (95% CI: 30%–89%) among children aged <11 months and 88% (95% CI: 76%–94%) among those aged 11 to 23 months, with sustained high effectiveness through 5 years of age (84%, 95% CI: 63%–93%). We observed a negative correlation between full vaccination coverage and hospitalization rates across municipalities (r = −0.155, p = 0.024). Conclusion Both full and partial rotavirus vaccination significantly reduced rotavirus-related hospitalizations among children in Slovenia. These findings support efforts to improve vaccine uptake and consideration of rotavirus vaccination inclusion in the NVP to reduce disease burden.20262026-03-19 08:35:29Neznano28430UDK: 616.2ISSN pri članku: 1873-2518DOI: 10.1016/j.vaccine.2026.128440COBISS_ID: 272192515sl