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Rotavirus vaccination among children indirectly protected adults from rotavirus
Pediatric rotavirus vaccination was linked to a nearly 50% decline in rotavirus identified in adult bacterial stool cultures during the peak rotavirus season, which indicated that pediatric rotavirus vaccination protected adults from rotavirus.
“In 2008, 2 years after reintroduction of rotavirus vaccination in the United States, a dramatic decline was observed in rotavirus disease among both vaccinated and unvaccinated children, suggesting indirect protection,” Evan J. Anderson, MD, assistant professor at the Emory University School of Medicine, and colleagues at Northwestern Memorial and Children’s Memorial Hospitals in Chicago wrote.
Evan J. Anderson
“Studies in adults with diarrhea report the prevalence of rotavirus in the US to be approximately 3% to 18% — we have previously identified rotavirus in about 5% of adults requiring hospitalization who had stool sent for bacterial stool culture between 1 February and 31 May 2006,” they wrote.
To determine the effect of pediatric vaccination on adult prevalence, patient characteristics and circulating rotavirus genotypes, Anderson and colleagues analyzed stools from 3,530 adults submitted for bacterial stool culture to Northwestern Memorial Hospital for clinically significant diarrhea.
In addition, all bacterial stool culture samples were processed for routine bacterial stool pathogens — such as Salmonella, Shigella, Campylobacter — but were not routinely tested for Escherichia coli O157:H7, Shiga toxin or Clostridium difficile.
Exclusion criteria for this cohort consisted of formed bacterial stool cultures, duplicates or bacterial stool cultures submitted less than 7 days apart and bacterial stool cultures from patients aged younger than 18 years. Additionally, bacterial stool cultures from patients who had been hospitalized more than 72 hours were also excluded to circumvent including patients with possible hospital-acquired diarrhea.
According to study results, the prevalence of rotavirus among adults who had stool sent for bacterial stool culture declined from 4.35% in 2006-2007 to 2.24% in 2008-2010 (a relative decline of 48.4%; P=.0007). The decline in the prevalence of rotavirus was of similar significant magnitude in both outpatients and inpatients.
About 30% of adults from whom rotavirus was isolated were immunocompromised, a figure which remained constant throughout the cohort.
“Our data document an almost 50% decline in the prevalence of rotavirus in adults during the peak rotavirus season,” Anderson and colleagues wrote. “This decline began in 2008 and coincides with similar declines in children that were observed after widespread pediatric rotavirus vaccination. This observation strongly suggests that pediatric rotavirus vaccination protects adults from rotavirus. Implementation of pediatric rotavirus vaccination should be encouraged for its substantial impact on the prevalence of rotavirus in unvaccinated adults as well as in children.”
Disclosure: The researchers reported consulting relationships, honoraria and advisory board positions with GlaxoSmithKline, Medscape, Merck and Theradoc.
