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 Researchers tracked hospitalizations for children under age 5 from
2009 to 2016, a period following the debut of two new rotavirus
vaccines in the U.S. They found that, compared to unvaccinated kids,
children who got just one dose of the rotavirus were 82% less likely
to be admitted to the hospital with a rotavirus infection and 75%
less likely to have an emergency department visit because of the
disease.
Kids who weren't vaccinated had severe rotavirus infections four
times more often than children who got the vaccines, the study also
found.
"Since the virus still exists throughout the environment and is very
easily transmitted, any hope of a child permanently avoiding a
rotavirus infection is unlikely," said Daniel Payne, lead author of
the study and a researcher at the U.S. Centers for Disease Control
and Prevention (CDC) in Atlanta.
"Eventually, all unvaccinated children will be exposed to infection,
and some of these infections will be severe," Payne said by email.
"Our study indicates that rotavirus vaccines significantly prevent
hospitalizations and severe infections when young children are
infected."
Rotavirus can cause severe watery diarrhea, vomiting, fever and
abdominal pain. Some children can become extremely dehydrated,
requiring hospitalization. If untreated, the condition can prove
fatal, but most children vaccinated against rotavirus will be spared
severe effects, according to the CDC.
The virus spreads in stool and can be easily passed from one child
to the next when they share toys or food, particularly while
children are still in diapers.
An older vaccine to prevent the virus, RotaShield, was introduced
and withdrawn in the U.S. in the late 1990s after it was linked to
intussusception in infants. Intussusception is a serious condition
that develops when the intestines become tangled and obstructed; it
can be fatal if not quickly treated.
Two new vaccines, RotaTeq and Rotarix, were approved for sale in the
U.S. in 2006 and 2008, respectively. So far, the potential for
intussusception appears extremely rare with these vaccines.
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Both vaccines are given to infants in oral drops in multiple doses
over several months; RotaTeq is administered three times, while
Rotarix is given twice.
In the study, there was no meaningful difference in outcomes based
on whether infants got RotaTeq or Rotarix.
Across the seven-year study period, an average of 87% of kids in the
study population had received at least one vaccine dose.
To assess the effectiveness of these vaccines, researchers examined
data from seven emergency rooms across the U.S., including a total
of 1,193 kids who had laboratory-confirmed rotavirus and 9,620 kids
who did not have the virus. All were treated for acute
gastroenteritis – defined as more than three episodes of diarrhea or
more than one of vomiting within the previous 24 hours.
In addition to protecting against hospital admissions, the vaccine
was associated with less-severe symptoms. Among kids with rotavirus,
17% of those who were not vaccinated had very severe symptoms
compared with 4.6% of kids who had been vaccinated.
The results suggest that the rotavirus vaccine should continue to be
recommended as a routine childhood vaccination, researchers conclude
in JAMA Network Open.
"Both rotavirus vaccines currently licensed in the U.S. continue to
be effective," Payne said.
"Our real-world study of rotavirus vaccine performance confirmed
that these vaccines are significantly reducing the clinical severity
of rotavirus infections in childhood."
SOURCE: https://bit.ly/2mCZzku JAMA Network Open, online September
27, 2019.
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