Rotavirus Vaccination in Australia: The Lowdown in the Down Under
Rotavirus vaccination was associated with a slightly increased intussusception risk that was offset by large reductions in rotavirus-associated hospitalizations in children younger than 5 years.
Australia approved two rotavirus vaccines, RV1 (Rotarix) and RV5 (RotaTeq), in 2007. As part of Australia's postmarketing surveillance, researchers compared intussusception in infants (aged 1 to 12 months) during the 21 days after rotavirus vaccination and during the period before or more than 21 days after vaccination. Using hospital discharge databases and active surveillance from 2007 through 2010, investigators identified 306 confirmed cases of intussusception.
After the first RV1 and RV5 doses, the relative incidence (RI) of intussusception was highest during week 1 (6.8 and 9.9, respectively) and dropped by 50% between weeks 1 and 3 (to 3.5 and 6.3, respectively). After the second dose of both vaccines, there was a smaller increased risk for intussusception (RI, 2.8). Researchers estimated that vaccination contributed to 18 additional cases of intussusception and prevented 6500 gastroenteritis admissions in children younger than 5 years. No child died from intussusception during the study period.
COMMENT
This small increased risk of intussusception immediately after rotavirus vaccination was largely offset by substantially fewer hospitalizations for gastroenteritis. Clinicians should discuss the risks and benefits of immunization with parents, though these data suggest that the large societal benefit may outweigh the small, but not insignificant, risk from rotavirus vaccination.
CITATION(S):
- Carlin JB et al. Intussusception risk and disease prevention associated with rotavirus vaccines in Australia's national immunisation program. Clin Infect Dis 2013 Aug 19; [e-pub ahead of print]. (http://dx.doi.org/10.1093/cid/cit520)
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