Difference in the distribution of onset age of intussusception after rotavirus vaccination and according to the type of rotavirus vaccine: single medical center study

Abstract Background Rotavirus infection has been proposed as a risk factor for coeliac disease (CD) and type 1 diabetes (T1D). The UK introduced infant rotavirus vaccination in 2013. We have previously shown that rotavirus vaccination can have beneficial off-target effects on syndromes, such as hospitalised seizures. We therefore investigated whether rotavirus vaccination prevents CD and T1D in the UK. Methods A cohort study of children born between 2010 and 2015 was conducted using primary care records from the Clinical Practice Research Datalink. Children were followed up from 6 months to 7 years old, with censoring for outcome, death or leaving the practice. CD was defined as diagnosis of CD or the prescription of gluten-free goods. T1D was defined as a T1D diagnosis. The exposure was rotavirus vaccination, defined as one or more doses. Mixed-effects Cox regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CIs). Models were adjusted for potential confounders and included random intercepts for general practices. Results There were 880,629 children in the cohort (48.8% female). A total of 343,113 (39.0%) participants received rotavirus vaccine; among those born after the introduction of rotavirus vaccination, 93.4% were vaccinated. Study participants contributed 4,388,355 person-years, with median follow-up 5.66 person-years. There were 1657 CD cases, an incidence of 38.0 cases per 100,000 person-years. Compared with unvaccinated children, the adjusted HR for a CD was 1.05 (95% CI 0.86–1.28) for vaccinated children. Females had a 40% higher hazard than males. T1D was recorded for 733 participants, an incidence of 17.1 cases per 100,000 person-years. In adjusted analysis, rotavirus vaccination was not associated with risk of T1D (HR = 0.89, 95% CI 0.68–1.19). Conclusions Rotavirus vaccination has reduced diarrhoeal disease morbidity and mortality substantial since licencing in 2006. Our finding from this large cohort study did not provide evidence that rotavirus vaccination prevents CD or T1D, nor is it associated with increased risk, delivering further evidence of rotavirus vaccine safety.

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Benign Convulsions with Mild Rotavirus and Norovirus Gastroenteritis: Nationwide Data from the Health Insurance Review and Assessment Service in South Korea

Children ◽

10.3390/children8040263 ◽

2021 ◽

Vol 8 (4) ◽

pp. 263

Author(s):

Dong Hyun Kim ◽

Dong Jun Ha ◽

Yeong Seok Lee ◽

Min Jun Chun ◽

Young Se Kwon

Keyword(s):

Health Insurance ◽

South Korea ◽

Large Scale ◽

Rotavirus Vaccine ◽

Annual Increase ◽

Rotavirus Vaccination ◽

Rotavirus Gastroenteritis ◽

Norovirus Gastroenteritis ◽

Increasing Trend

There have been no large-scale studies on the epidemiology of benign convulsions with mild gastroenteritis (CwG) since the introduction of the rotavirus vaccine in South Korea in 2007. This study aimed to analyze the trends in rotavirus gastroenteritis (RVGE) and rotavirus-associated CwG (RaCwG) after rotavirus vaccination. Further, we aimed to analyze changes in norovirus gastroenteritis (NVGE) and norovirus-associated CwG (NaCwG) using nationwide data from the Korean Health Insurance Review and Assessment Service. Between 2007 and 2019, this study analyzed children aged <6 years who were diagnosed with RVGE, NVGE, RaCwG and NaCwG. The changes in the prevalence of each disease and the ratio of CwG to enteritis were analyzed and the effects of age, sex and season were also analyzed. RVGE, RaCwG, NVGE and NaCwG were diagnosed in 273,898, 4246, 35,593 and 337 patients, respectively. The prevalence of RVGE was on a decreasing trend every year, but the prevalence of NaCwG and NVGE was on an increasing trend. There was a significant annual increase in the ratio of CwG to enteritis in both viruses. In order to control the prevalence of RaCwG, measures other than the rotavirus vaccine are required and measures to prevent norovirus are necessary.

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Impact of Monovalent Rotavirus Vaccine on Rotavirus Hospitalizations among Children Younger Than 5 Years of Age in the Ouest and Artibonite Departments, Haiti, 2013 to 2019

American Journal of Tropical Medicine and Hygiene ◽

10.4269/ajtmh.21-0414 ◽

2021 ◽

Author(s):

Anne-Marie Desormeaux ◽

Eleanor Burnett ◽

Gérard Joseph ◽

Mentor Ali Ber Lucien ◽

Negar Aliabadi ◽

...

Keyword(s):

Negative Binomial ◽

Hospital Admissions ◽

Absolute Number ◽

Sensitivity Analyses ◽

Rotavirus Vaccine ◽

Vaccine Introduction ◽

Rotavirus Vaccination ◽

Before And After ◽

Rotavirus Diarrhea ◽

The Impact

Rotavirus is responsible for 26% of diarrheal deaths in Latin America and the Caribbean. Haiti introduced the monovalent rotavirus vaccine in April 2014. The objective of this analysis is to describe the impact of the rotavirus vaccine on hospitalizations among Haitian children younger than 5 years old during the first 5 years after introduction. This analysis includes all children with diarrhea who were enrolled as part of a sentinel surveillance system at two hospitals from May 2013 to April 2019. We compare the proportion of rotavirus-positive specimens in each post-vaccine introduction year to the pre-vaccine period. To account for the potential dilution of the proportion of rotavirus-positive specimens from a waning cholera outbreak, we also analyzed annual trends in the absolute number of positive stools, fit a two-component finite-mixture model to the negative specimens, and fit a negative binomial time series model to the pre-vaccine rotavirus-positive specimens to predict the number of rotavirus diarrhea hospital admissions in the absence of rotavirus vaccination. The overall percentage of rotavirus-positive specimens declined by 22% the first year after introduction, increased by 17% the second year, and declined by 33% to 50% the subsequent 3 years. All sensitivity analyses confirmed an overall decline. We observed a clear annual rotavirus seasonality before and after vaccine introduction, with the greatest activity in December through April, and a biennial pattern, with high sharp peaks and flatter longer periods of increased rotavirus activity in alternating years, consistent with suboptimal vaccination coverage. Overall, our study shows evidence that the introduction of the rotavirus vaccine reduced the burden of severe rotavirus diarrhea.

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Safety and Efficacy of High-dose Rhesus-Human Reassortant Rotavirus Vaccines-Report of the National Multicenter Trial

PEDIATRICS ◽

10.1542/peds.98.1.a38a ◽

1996 ◽

Vol 98 (1) ◽

pp. A38-A38 ◽

Cited By ~ 1

Author(s):

Margaret B. Rennels ◽

Roger I. Glass ◽

Penelope H. Dennehy ◽

David I. Bernstein ◽

Michael E. Pichichero ◽

...

Keyword(s):

United States ◽

Medical Center ◽

The United States ◽

Multicenter Trial ◽

High Dose ◽

Rotavirus Vaccine ◽

Kaiser Permanente ◽

Safety And Efficacy ◽

Rotavirus Vaccines ◽

Medical Office

In the January 1996 article titled "Safety and Efficacy of High-dose Rhesus Human Reassortant Rotavirus Vaccines—Report of the National Multicenter Trial" (Rennels et al. Pediatrics, 1996:97:7-13), the Acknowledgments section on page 12 included an incorrect location for one member of the United States Rotavirus Vaccine Efficacy Group, and another member was inadvertently omitted. The correct list should include: Stephen Fries, MD, Boulder Medical Center, Boulder, CO; and Hervey Froehlich, MD, Kaiser Permanente Medical Office, Fresno, CA.

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Global Impact of Rotavirus Vaccination on Diarrhea Hospitalizations and Deaths Among Children <5 Years Old: 2006–2019

The Journal of Infectious Diseases ◽

10.1093/infdis/jiaa081 ◽

2020 ◽

Vol 222 (10) ◽

pp. 1731-1739 ◽

Cited By ~ 13

Author(s):

Eleanor Burnett ◽

Umesh D Parashar ◽

Jacqueline E Tate

Keyword(s):

Age Groups ◽

Published Data ◽

Rotavirus Vaccine ◽

Immunization Programs ◽

Median Percentage ◽

Global Impact ◽

Vaccine Introduction ◽

Rotavirus Vaccination ◽

Younger Age ◽

Before And After

Abstract Background Since 2006, more than 100 countries have introduced rotavirus vaccine into their immunization programs. We reviewed published data on relative reductions of rotavirus hospitalizations, acute gastroenteritis (AGE) hospitalizations, and AGE deaths among children <5 years old. Methods Articles published from January 1, 2006 to December 31, 2019 with at least 12 months of data before and after rotavirus vaccine introduction were included. Relative reductions were abstracted into a standardized form. Descriptive statistics are presented as medians and interquartile ranges (IQRs). Results We reviewed 1827 total records and included 105 articles from 49 countries. Among children <5 years old, there was a median reduction of 59% (IQR, 46–74) in rotavirus hospitalizations, 36% (IQR, 23–47) in AGE hospitalizations, and 36% (IQR, 28–46) AGE mortality. Reductions were larger in countries with low child mortality, among younger age groups, and in countries with higher coverage. The median percentage of specimens that tested positive for rotavirus among children <5 years old hospitalized for diarrhea was 40% (IQR, 28–45) before rotavirus vaccine introduction and 20% (IQR, 20–20) 4 years after introduction. Conclusions Overall, we found sustained impact on rotavirus and AGE hospitalizations and deaths. These results should encourage countries still considering rotavirus vaccine implementation.

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Summary of effectiveness and impact of rotavirus vaccination with the oral pentavalent rotavirus vaccine: A systematic review of the experience in industrialized countries

Human Vaccines ◽

10.4161/hv.7.7.15511 ◽

2011 ◽

Vol 7 (7) ◽

pp. 734-748 ◽

Cited By ~ 47

Author(s):

Carlo Giaquinto ◽

Geraldine Dominiak-Felden ◽

Pierre Van Damme ◽

Tin Tin Htar Myint ◽

Yvonne A. Maldonado ◽

...

Keyword(s):

Systematic Review ◽

Rotavirus Vaccine ◽

Industrialized Countries ◽

Rotavirus Vaccination

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1491. Active Norovirus Surveillance in Children Under 5 Years with Diarrhea after Rotavirus Vaccine Introduction in Argentina (2017–2019)

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1355 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S543-S543

Author(s):

Angela Gentile ◽

Juan Stupka ◽

Juan I Degiuseppe ◽

María del Valle Juárez ◽

Maria Florencia Lucion ◽

...

Keyword(s):

Acute Diarrhea ◽

Epidemiological Data ◽

Cross Sectional Study ◽

Epidemiological Surveillance ◽

Watery Diarrhea ◽

Rotavirus Vaccine ◽

Cross Sectional ◽

Vaccine Introduction ◽

Rotavirus Vaccination ◽

Children Under 5

Abstract Background Acute diarrhea is one of the leading causes of infant morbidity and mortality. Argentina introduced massive rotavirus vaccination in 2015. In several countries, this introduction has changed the distribution of enteropathogens. The decrease in the prevalence of rotavirus has been described at the expense of an increase in Norovirus (NoV) activity worldwide. The aim of this study was to analyze the role of NoV in acute diarrhea cases in outpatient children under 5 years of age and their epidemiological profile. Methods A prospective and cross-sectional study in <5 years outpatients attended for acute diarrhea in Children’s Hospital “Dr. Ricardo Gutiérrez” in Buenos Aires, Argentina, between July 2017 and March 2019 was conducted. Active epidemiological surveillance was performed with a specific case reporting form. Stool samples were tested for NoV (RT-qPCR). Clinical and epidemiological data were recorded. Results A total of 252 patients were enrolled and 235 stools samples were tested. Median of age was 22.3 months (IQR: 11–30), 58.7% were male. The most frequent symptoms were fever and vomiting in 63.1% and 53%, respectively; 52% had watery diarrhea, 45.2% had moderate diarrhea according to Vesikari Scale, 95.6% were normohydrated and 22% had a household member with diarrhea. There were no immunocompromised children. A 72% had received rotavirus vaccine, 86% of them with full scheme. From samples tested, 27% (n = 63) were NoV positive. NoV was found throughout the year and the frequency of detection was higher in January and June (summer and winter in Argentina). Regarding genetic diversity the most frequent genogroup was GII (65%; 41/63) and genotype GII.P16-GII.4 Sydney (48%; 20/41). Bacterial co-infection was observed in 35%. Compared with negative cases, NoV were younger (18 vs. 20 months; P < 0.001) and were associated with higher prevalence of rotavirus vaccination (88% vs. 66%; P = 0.001). No statistically difference was found regarding to gender, clinical outcome and severity. Conclusion NoV was detected at high frequency (27%) in children presenting moderate acute diarrhea, mainly in those who received rotavirus vaccine. Regarding sporadic acute diarrhea cases in children, it is important to consider NoV as a frequent etiological agent. Disclosures All authors: No reported disclosures.

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Risk of invasive fungal infections in patients with multiple myeloma receiving novel therapies: a single Asian medical center study

Clinical Lymphoma Myeloma & Leukemia ◽

10.1016/j.clml.2015.07.418 ◽

2015 ◽

Vol 15 ◽

pp. e188

Author(s):

P. Hsu ◽

Y.T. Lee ◽

C.M. Yeh ◽

T.W. Lin ◽

J.H. Liu ◽

...

Keyword(s):

Multiple Myeloma ◽

Fungal Infections ◽

Medical Center ◽

Invasive Fungal Infections ◽

Novel Therapies ◽

Center Study

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Diarrheal Diseases Hospitalization in Yemen before and after Rotavirus Vaccination

Scientifica ◽

10.1155/2016/8485417 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Mohammed Amood AL-Kamarany ◽

Lina Al-Areqi ◽

Abulatif Mujally ◽

Fawzya Alkarshy ◽

Arwa Nasser ◽

...

Keyword(s):

Vaccine Coverage ◽

Rotavirus Vaccine ◽

Diarrheal Diseases ◽

Predominant Genotype ◽

Fecal Samples ◽

Vaccine Introduction ◽

Rotavirus Vaccination ◽

Before And After ◽

Rotavirus Diarrhea ◽

The Impact

The study aims to assess the impact of rotavirus vaccine introduction on diarrheal diseases hospitalization and to identify the rotavirus genotypes most prevalent before and after vaccine introduction among children ≤ 5 years of age. Rotarix™® rotavirus vaccine is currently licensed for infants in Yemen and was introduced in 2012. The vaccination course consists of two doses. The first dose is administrated at 6 weeks of age and the second dose is completed by 10 weeks. Based on a longitudinal observational study, we assessed the impact of vaccination on rotavirus hospitalization before and after vaccination among children ≤ 5 years of age at the Yemeni-Swedish Hospital (YSH) in Taiz, Yemen. Prevaccination covered January 2009–July 2012 during which 2335 fecal samples were collected from children ≤ 5 years old. Postvaccination covered January 2013–December 2014 during which 1114 fecal samples were collected. Rotavirus was detected by Enzyme Linkage Immunosorbent Assay (ELISA). The incidence ofrotavirushospitalization decreased from 43.79% in 2009 to 10.54% in 2014. Hospitalization due to rotavirus diarrhea was reduced by 75.93%. Vaccine coverage increased from 23% in 2012 to 72% in 2014. Also, the results showed that the most predominant genotypes in prevaccination period were G2P[4] (55.0%), followed by G1P[8] (15.0%), while in postvaccination period G1P[8] (31%) was the predominant genotype, followed by G9P[8] (27.5%). In conclusion, rotavirus vaccination in Yemen resulted in sharp reduction in diarrheal hospitalization. A successful rotavirus vaccination program in Yemen will rely upon efficient vaccine delivery systems and sustained vaccine efficacy against diverse and evolving rotavirus strains.

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Rotavirus symptomatic infection among unvaccinated and vaccinated children in Valencia, Spain

BMC Infectious Diseases ◽

10.1186/s12879-019-4550-x ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Raúl Pérez-Ortín ◽

Cristina Santiso-Bellón ◽

Susana Vila-Vicent ◽

Noelia Carmona-Vicente ◽

Jesús Rodríguez-Díaz ◽

...

Keyword(s):

Vaccine Coverage ◽

National Health System ◽

Epidemiological Data ◽

Immunological Methods ◽

Rotavirus Vaccine ◽

Symptomatic Infection ◽

Rotavirus Infection ◽

Rotavirus Vaccination ◽

Group A ◽

Rotavirus Infections

Abstract Background Human group A rotavirus is the leading cause of severe acute gastroenteritis in young children worldwide. Immunization programs have reduced the disease burden in many countries. Vaccination coverage in the Autonomous Region of Valencia, Spain, is around 40%, as the rotavirus vaccine is not funded by the National Health System. Despite this low-medium vaccine coverage, rotavirus vaccination has substantially reduced hospitalizations due to rotavirus infection and hospital-related costs. However, there are very few studies evaluating symptomatic rotavirus infections not requiring hospitalization in vaccinated children. The objective of this study was to investigate symptomatic rotavirus infections among vaccinated children in the health area served by the Hospital Clínico Universitario of Valencia, Spain, from 2013 to 2015. Methods A total of 133 children younger than 5 years of age with rotavirus infection were studied. Demographic and epidemiological data were collected and informed consent from their caretakers obtained. Rotavirus infection was detected by immunological methods and G/P rotavirus genotypes were determined by RT-PCR, following standard procedures from the EuroRotaNet network. Results Forty infants (30.1%; 95% CI: 22.3–37.9) out of 133 were diagnosed with symptomatic rotavirus infection despite having been previously vaccinated, either with RotaTeq (85%) or with Rotarix (15%). Children fully vaccinated against rotavirus (24.8%), partially vaccinated (5.3%) and unvaccinated (69.9%) were found. The infecting genotypes showed high G-type diversity, although no significant differences were found between the G/P genotypes infecting vaccinated and unvaccinated children during the same time period. G9P[8], G12P[8] and G1P[8] were the most prevalent genotypes. Severity of gastroenteritis symptoms required 28 (66.6%) vaccinated and 67 (73.6%) unvaccinated children to be attended at the Emergency Room. Conclusion Rotavirus vaccine efficacy in reducing the incidence of severe rotavirus infection has been well documented, but symptomatic rotavirus infection can sometimes occur in vaccinees.

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