Intussusception Risk and Health Benefits of Rotavirus Vaccination in Mexico and Brazil

Patel, Manish; López-Collada, Vesta Richardson; Bulhões, Marília Mattos; Oliveira, Lúcia Helena de; Márquez, A; Flannery, Brendan; Esparza-Aguilar, Marcelino; Renoiner, Ernesto Isaac Montenegro; Luna-Cruz, Maria; Sato, Helena Keico; Hernández-Hernández, Luz del Carmen; Toledo-Cortina, Gerardo; Cerón‐Rodríguez, Magdalena; Osnaya-Romero, Neydi; Martínez-Alcazar, Mario; Aguinaga-Villasenor, Rocío Gabriela; Plascencia-Hernández, Arturo; Fojaco-González, Francisco; Rezk, Guillermo Hernández-Peredo; Gutiérrez-Ramírez, Sixto F.; Dorame-Castillo, Roberto; Tinajero-Pizano, Rogelio; Mercado-Villegas, Bernice; Barbosa, Marilia Reichelt; Maluf, Eliane Mara Cesário Pereira; Ferreira, Lucimar Bozza; Carvalho, Francisca Maria de; Santos, Ana Rosa dos; Cesar, Eduardo Dolabella; Oliveira, Maria Elisa Paula de; Silva, Carmem Lúcia Osterno; Cortes, Maria de Los Angeles; Matus, Cuauhtémoc Ruiz; Tate, Jacqueline E.; Gargiullo, Paul; Parashar, Umesh D.

doi:10.1056/nejmoa1012952

Cited by 346 publications

(227 citation statements)

References 22 publications

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“…Title and abstract screening resulted in the identification of 16 potentially relevant publications. Ten of these 16 studies met the inclusion criteria for the meta-analysis (Table 1) (18,(26)(27)(28)(29)(30)(31)(32)(33)(34). The publications not included in the full text screening are listed as references e2-e7.…”

Section: Resultsmentioning

confidence: 99%

“…The publications not included in the full text screening are listed as references e2-e7. In the case of the study by Patel et al (18), only data from Mexico were included; the results from Brazil were ignored, because in Brazil the oral polio vaccine (OPV) was given in parallel with the first dose of RV vaccine. Administration of these two live vaccines in parallel appears to reduce the immunogenicity of the RV vaccine and therefore also to mask the possible intussusception risk (35).…”

Section: Resultsmentioning

confidence: 99%

“…The German Standing Committee on Vaccination (STIKO, Ständige Impfkommission) published its recommendation that infants should receive RV vaccination in August 2013. Based on data from observational studies available at that time, the risk was estimated to be 1 to 2 additional intussusceptions per 100 000 vaccinated infants, irrespective of which vaccine was used (13)(14)(15)(16)(17)(18)(19)(20)(21)(22). STIKO states explicitly that the vaccination is associated with a slightly increased risk of intussusception during the first week after the first dose of vaccine.…”

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confidence: 99%

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Risk of Intussusception After Rotavirus Vaccination

Koch¹,

Harder²,

Kries³

et al. 2017

Deutsches Ärzteblatt International

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SUMMARYBackground: In 2013, the German Standing Committee on Vaccination (Stän-dige Impfkommission, STIKO) recommended rotavirus (RV) vaccination for all infants while stating that this mildly increased the risk of intussusception, a potentially life-threatening event. Since this recommendation was issued, multiple observational studies on this topic designed as self-controlled case series (SCCS) have been published. The SCCS design is particularly suitable for the study of rare adverse effects of medications.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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confidence: 99%

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Risk of Intussusception After Rotavirus Vaccination

Koch¹,

Harder²,

Kries³

et al. 2017

Deutsches Ärzteblatt International

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“…29,30 The safety and efficacy of alternate dosing with the two current rotavirus vaccines have not been studied, hence the interchangeability of these vaccines is unknown. Moreover, no available evidence suggests that either rotavirus diarrhea in US and many other developed nations without significant increase in risk of intussusception.…”

Section: Overview Of Available Rotavirus Vaccinesmentioning

confidence: 99%

Rotavirus vaccine: A cost effective control measure for India

Kumar

Goel

Jain

et al. 2012

Human Vaccines & Immunotherapeutics

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Globally, rotavirus diarrhea results in 453,000 deaths in children younger than 5 y-37% of deaths attributable to diarrhea and 5% of all deaths in children younger than 5 y. India alone accounts for 22% (~100,000 deaths) of all deaths attributable to rotavirus infection. Two oral rotavirus vaccines are available: Rotarix, a monovalent P1A[8] G 1 vaccine (GlaxoSmithKline), and RotaTeq, a pentavalent bovine-human reassortant vaccine (Merck). Rotarix is administered in a 2-dose schedule with the first and second doses of DTP (DTP1, DTP2). RotaTeq requires a 3-dose schedule with DTP1, DTP2 and DTP3 with an interval of 4-10 weeks between doses. The first dose of either vaccine should be administered to infants aged 6-15 weeks irrespective of the history of previous rotavirus infection, and the maximum age for administering the last dose of either vaccine should be 32 weeks. Although India would require funding from international health organizations/ GAVI until new indigenous rotavirus vaccine candidates are developed at a cheaper price, introduction of vaccination into the national immunization program would be a cost-effective step toward control of the rotavirus diarrhea-related morbidity and mortality in India.

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“…6 Consequently, the impact of vaccination on rotavirus disease and death in low-income countries of Africa and Asia has not been established. In addition, the two current rotavirus vaccines have been associated with a low risk (1:~50 000) of intussusception among vaccinated infants 7,8 and diarrhea…”

mentioning

confidence: 99%