Rotavirus-associated hospitalization and emergency department costs and rotavirus vaccine program impact.

•Economic burden of rotavirus medical visits has been estimated by indirect measures.•Indirect measures led to uncertainty of the true medical cost of rotavirus disease.•This study used direct methods to identify children with rotavirus medical visits.•This study found high medical costs prior to rotavirus vaccine licensure in the US.•This study found a dramatic decline in costs after introduction of rotavirus vaccines.