Issue: February 2018
February 01, 2018
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Pediatric hospitalizations for seizures fall after introduction of rotavirus vaccines

Issue: February 2018
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Pediatric hospitalizations for seizures have fallen since the introduction of the rotavirus vaccine, according to findings published in The Journal of Infectious Diseases.

“Following the introduction of rotavirus vaccines in the United States in 2006, rotavirus diarrhea hospitalizations among children aged younger than 5 years declined substantially,” Jacqueline E. Tate, PhD, epidemiologist at the National Center for Immunization and Respiratory Diseases, told Infectious Disease News. “In addition to acute gastroenteritis, rotavirus infections have also been associated with seizures, but the impact of rotavirus vaccination on seizures in children has not been extensively studied.”

The CDC’s Advisory Committee on Immunization Practices (ACIP) first recommended routine vaccination with RotaTeq (Merck) for infants in 2006. In 2008, these recommendations were expanded to include vaccination with Rotarix (GlaxoSmithKline Biologicals). Both are live oral rotavirus vaccines.

The researchers evaluated data from children aged younger than 5 years who were hospitalized for seizures, using discharge codes from the State Inpatient Databases of the Healthcare Cost and Utilization Project. Tate and colleagues compared rates of seizure hospitalizations from before and after the introduction of the vaccines.

The researchers reviewed a total of 962,899 hospitalizations for seizures between 2000 and 2013. Most hospitalizations (55%) occurred in boys, the researchers reported. Newborns accounted for approximately one-fifth of the population (22%), whereas those aged 24 to 35 months made up 14% of the population.

Annual seizure hospitalization rates among all children aged younger than 5 years decreased by 1% to 8% after vaccine introduction, Tate and colleagues wrote, with rate ratios decreasing over time.

When the researchers stratified hospitalization results by month and year, they reported that estimated rate ratios for January through June — peak rotavirus season — were lower than those of the rest of the year. The greatest reduction in season-specific seizure rates occurred among children aged 12 to 17 months, falling from 553 cases per 100,000 population before vaccine introduction to 493 cases per 100,000 after introduction.

Rates also fell among children aged 18 to 23 months, although this was less pronounced, the researchers wrote. There was no consistent decrease among children aged 6 to 11 months.

“The contribution of rotavirus infection to this seizure burden has been largely unappreciated,” Tate said. “The reduction in seizure hospitalizations following rotavirus vaccine introduction is an unexpected but important additional benefit of the vaccination program and supports continued routine rotavirus vaccination in the United States.” – by Andy Polhamus

Disclosures: The authors report no relevant financial disclosures.