Protective Association Between Rotavirus Vaccination and Childhood Seizures in the Year Following Vaccination in US Children

Abstract

Background Rotavirus illness has been linked to childhood seizures. We investigated whether a protective association exists between receipt of rotavirus vaccine and being hospitalized or visiting the emergency department for seizures in the year after vaccination. Methods We retrospectively analyzed a cohort of children born after 28 February 2006 (when rotavirus vaccine was licensed in the United States) and enrolled in the Vaccine Safety Datalink (VSD) through November 2009. Seizure rates from 4 to 55 weeks following last rotavirus vaccination were compared by vaccine exposure status (fully vaccinated and unvaccinated). A time-to-event analysis using a Cox proportional hazards model was performed, accounting for time-varying covariates. We calculated the relative incidence of seizure compared by vaccine exposure status during the postexposure interval. Results Our cohort contained VSD data on 250 601 infants, including 186 502 children fully vaccinated (74.4%) and 64 099 (25.6%) not vaccinated with rotavirus vaccine. Rates of seizures were associated with rotavirus vaccination status. After adjusting for covariates (VSD site, age at last dose, sex, and calendar month of the index date), a statistically significant protective association was observed between a full course of rotavirus vaccination vs no vaccination for both first-ever seizures (risk ratio [RR] = 0.82; 95% confidence interval [CI], .73–.91) and all seizures (RR = 0.79; 95% CI, .71–.88). Conclusions A full course of rotavirus vaccination was statistically associated with an 18%–21% reduction in risk of seizure requiring hospitalization or emergency department care in the year following vaccination, compared with unvaccinated children. This reduction in childhood seizures complements the well-documented vaccine-related benefit of preventing US diarrhea hospitalizations.

Vaccination Against Rotavirus Infection: 10-Year Global Experience of Successful Use

“…уже сумели продемон-стрировать защитный эффект вакцинации против вне-кишечных проявлений РВИ. Так, в крупномасштабном исследовании (n=250 000) было показано, что полный курс вакцинации против ротавируса в течение 1 года приводит к снижению частоты первого эпизода разви-тия судорог на 18% у привитых младенцев в сравнении с невакцинированными детьми и на 21% -при всех эпизодах судорог [78].…”

Mucosal Immunity and acute viral gastroenteritis

“…Encouragingly, immune responses (serum anti-rotavirus IgA and serum neutralizing antibodies against human rotavirus serotypes in the vaccine) rose in this population after a single dose of RV5, despite their older age and pre-existing rotavirus-specific antibodies. 10 In conclusion, rotavirus immunization by oral vaccines is effective in providing protection from rotavirus disease, a major public health problem extending beyond diarrhea alone.…”

Assessing vaccine effectiveness of publicly funded vaccination programs in Queensland

“…An unexpected benefit associated with rotavirus vaccine was described recently in a study undertaken in the US, which identified a protective association between rotavirus vaccination and febrile and afebrile seizures in children (99). Rotavirus vaccination was found to be associated with an 18% to 21% reduction in hospitalisation or ED presentation for seizures in the year following vaccination compared to children not receiving rotavirus vaccination (99).…”

“…Rotavirus vaccination was found to be associated with an 18% to 21% reduction in hospitalisation or ED presentation for seizures in the year following vaccination compared to children not receiving rotavirus vaccination (99). Due to creation of a large linked dataset for my study to assess the vaccine effectiveness of rotavirus vaccine in preventing rotavirus-associated hospital presentations and admissions, I had the opportunity to assess the effectiveness of rotavirus vaccine in preventing febrile seizures in an Australian context.…”

“…Recently, a retrospective analysis of a cohort of US children found a protective association between full rotavirus vaccination and childhood seizures resulting in emergency department (ED) presentation or hospital admission in the year following vaccination (99). Using a pre-existing linked dataset containing febrile, but not afebrile, seizure outcome data, we sought evidence of a similar effect in children in Queensland, Australia, after introduction of the publicly funded (Table).…”