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Intussusception hospitalizations rise in some infants after initial RV vaccination
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A spike in intussusception hospitalization rates occurred in children aged 8 to 11 weeks after children received initial doses of RotaTeq or Rotarix vaccine for rotavirus compared with prevaccine years, according to recent study results.
“A previous study of U.S. hospital discharge data found a small increased risk of intussusception hospitalizations among children 8 to 11 weeks of age in 2007 through 2009 compared with a prevaccine baseline from 2000 through 2005 but no sustained population level change intussusception hospitalization rates among all children less than 12 months of age,” Jacqueline E. Tate, PhD, from the division of viral diseases at the National Center for Immunization and Respiratory Diseases at the CDC, and colleagues wrote. “The objective of the current analysis is to update the previous analysis with 4 additional years of postvaccine introduction data from 2010 through 2013 to examine trends among all children less than 12 months of age as well as children in the age groups during which doses of (rotavirus vaccine [RotaTeq, Merck or Rotarix, GlaxoSmithKline; RV]) are recommended.”
Tate and colleagues pooled hospitalization rates of children from the State Inpatient Databases for 26 states that provided data annually from 2000 to 2013. The researchers analyzed trends for patients aged 6 to 14 weeks, 15 to 24 weeks and 25 to 34 weeks based on recommended ages to receive RV vaccinations. They also calculated rates with bridged-race postcensal population estimates, and they examined intussusception hospitalization rates in children 8 to 11 weeks specifically, when the majority of first dose administration occurred.
The researchers identified 15,231 intussusception hospitalizations in children aged younger than 12 months in the retrospective period. Among children aged 15 to 24 weeks and 25 to 34 weeks, analysis demonstrated no consistent or significant change in hospitalization rates before and after vaccinations. Infants aged 8 to 11 weeks, however, demonstrated a statistically significant increase in intussusception hospitalization from 46% to 101% (range: 16.7-22.9 per 100,000) in all postvaccine years vs. prevaccine baseline (11.4 per 100,000) except for 2011 (15,000 per 100,000) and 2013 (14.7 per 100,000).
“In our ecological evaluation, a small increased risk of intussusception was observed in children 8 to 11 weeks of age when the majority of rotavirus vaccine doses are given, and this increase is consistent with a small increased risk of intussusception observed in the first week after the first dose in postmarketing studies,” the researchers wrote. “However, given the magnitude of the declines in rotavirus disease compared with the small increased risk of intussusception, the public health benefits of rotavirus vaccination far exceed the increased risk of intussusception.” – by Kate Sherrer
Disclosure: The researchers report no relevant financial disclosures.
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