1
|
Li Y, Sun X, Fu Y, You X, Hartwig S. Literature review to identify evidence of secondary transmission of pentavalent human-bovine reassortant rotavirus vaccine (RV5) strains to unvaccinated subjects. Vaccine 2024; 42:1461-1468. [PMID: 38355319 DOI: 10.1016/j.vaccine.2024.01.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/22/2024] [Accepted: 01/24/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND Rotavirus is the leading cause of severe diarrhea in infants and young children. Live attenuated vaccines can lead to horizontal transmission with the risk of vaccine-derived disease in contacts. Transmission of pentavalent human-bovine reassortant rotavirus vaccine (RV5) strains leading to clinical disease was not well evaluated in the pivotal clinical trials, and only a few case reports have been described in the literature. METHODS We performed a systematic literature review to investigate secondary transmission of RV5 strains to unvaccinated subjects globally. We searched Embase, Medline for English papers, CNKI, Wan Fang for Chinese papers, and other resources (i.e., conference papers with full text) from January 2005 to June 2021. Eligibility criteria for inclusion were original articles based on non-interventional studies (case-control studies, cohort studies, cross-sectional studies) using RV5 strain transmission as outcomes. Other study or publication types were excluded, such as pre-clinical studies, interventional studies and case reports. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used, and study quality was assessed using the Newcastle-Ottawa Scale (NOS) for cohort studies and the JBI checklist for cross-sectional studies to assess the risk of bias. RESULTS The search generated 2,089 articles in total. Seven articles met all inclusion criteria, including six cohort studies and one cross-sectional study. All studies underwent quality assessment and complied with the quality criteria of the NOS or JBI checklist, respectively. Overall, none of the seven studies identified RV5 vaccine-type transmission to an unvaccinated population, in either hospitals or nurseries under a close contact environment. One study reported that 1% of unvaccinated infants had gastrointestinal symptoms, but all symptoms were attributed to other clinical conditions. CONCLUSIONS We found no evidence of horizontal transmission of RV5 strains to unvaccinated infants in a context of a limited amount and the descriptive nature of the identified studies.
Collapse
Affiliation(s)
- Yuanqiu Li
- MSD Research and Development (China) Co., Ltd., Beijing, China
| | - Xiaojin Sun
- MSD Research and Development (China) Co., Ltd., Beijing, China
| | - Yaqun Fu
- MSD Research and Development (China) Co., Ltd., Beijing, China
| | | | | |
Collapse
|
2
|
Marcinek K, Zapolnik P, Radziszewska R, Ochoda-Mazur A, Czajka H, Pawlik D. Rotavirus Vaccination of Premature Newborns in the NICU: Evaluation of Vaccination Rates and Safety Based on a Single-Centre Study. Vaccines (Basel) 2023; 11:1282. [PMID: 37631849 PMCID: PMC10458254 DOI: 10.3390/vaccines11081282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/16/2023] [Accepted: 07/24/2023] [Indexed: 08/27/2023] Open
Abstract
Preterm newborns are babies born before the end of the 36th week of gestational life. They are at increased risk of infection and death from infectious diseases. This is due, among other things, to the immaturity of the immune system and the long hospitalisation period. One common infectious disease in the paediatric population is rotavirus (RV) infection. We now have specific vaccines against this pathogen. The aim of this study was to evaluate the safety of rotavirus vaccination in the neonatal intensive care unit (NICU) setting and to determine the tolerance of this vaccine in low- and extremely low-weight children. The study carried out at a single centre, the University Hospital in Kraków, also allowed the assessment of vaccination trends during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. During the observation period, 126 premature newborns received the RV vaccine. We observed no adverse effects, and our analysis shows safety and good tolerance of the vaccine among preterm babies. In addition, we observed an increase in vaccination rates between 2019 and 2021, partly explained by parents' anxiety about infectious diseases in the era of pandemics and partly explained by a change in vaccination policy in Poland and the introduction of refunding for RV vaccination.
Collapse
Affiliation(s)
- Klaudia Marcinek
- Neonatology Clinical Department, University Hospital in Kraków, 31-501 Kraków, Poland
| | - Paweł Zapolnik
- College of Medical Sciences, University of Rzeszów, 35-315 Rzeszów, Poland
| | | | | | - Hanna Czajka
- College of Medical Sciences, University of Rzeszów, 35-315 Rzeszów, Poland
| | - Dorota Pawlik
- Medical College, Jagiellonian University, 31-008 Kraków, Poland
| |
Collapse
|
3
|
Costantino C, Conforto A, Bonaccorso N, Cimino L, Sciortino M, Palermo M, Maiolo K, Tina LG, Betta PM, Caracciolo M, Loretta CM, Arco A, Gitto E, Vitaliti SM, Mancuso D, Vitaliti G, Rosella V, Pinello G, Corsello G, Serra G, Gabriele B, Tramuto F, Restivo V, Amodio E, Vitale F. Safety of Rotavirus Vaccination in Preterm Infants Admitted in Neonatal Intensive Care Units in Sicily, Italy: A Multicenter Observational Study. Vaccines (Basel) 2023; 11:vaccines11040718. [PMID: 37112630 PMCID: PMC10145326 DOI: 10.3390/vaccines11040718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/16/2023] [Accepted: 03/21/2023] [Indexed: 04/29/2023] Open
Abstract
Rotavirus (RV) is among the most common vaccine-preventable diseases in children under five years of age. Despite the severity of rotavirus pathology in early childhood, rotavirus vaccination for children admitted to the neonatal intensive care unit (NICU), who are often born preterm and with various previous illnesses, is not performed. This multicenter, 3-year project aims to evaluate the safety of RV vaccine administration within the six main neonatal intensive care units of the Sicilian Region to preterm infants. Methods: Monovalent live attenuated anti-RV vaccination (RV1) was administered from April 2018 to December 2019 to preterm infants with gestational age ≥ 28 weeks. Vaccine administrations were performed in both inpatient and outpatient hospital settings as a post-discharge follow-up (NICU setting) starting at 6 weeks of age according to the official immunization schedule. Any adverse events (expected, unexpected, and serious) were monitored from vaccine administration up to 14 days (first assessment) and 28 days (second assessment) after each of the two scheduled vaccine doses. Results: At the end of December 2019, 449 preterm infants were vaccinated with both doses of rotavirus vaccine within the six participating Sicilian NICUs. Mean gestational age in weeks was 33.1 (±3.8 SD) and the first dose of RV vaccine was administered at 55 days (±12.9 SD) on average. The mean weight at the first dose was 3388 (SD ± 903) grams. Only 0.6% and 0.2% of infants reported abdominal colic and fever above 38.5 °C in the 14 days after the first dose, respectively. Overall, 1.9% EAEs were observed at 14 days and 0.4% at 28 days after the first/second dose administration. Conclusions: Data obtained from this study confirm the safety of the monovalent rotavirus vaccine even in preterm infants with gestational age ≥ 28 weeks, presenting an opportunity to improve the vaccination offer both in Sicily and in Italy by protecting the most fragile infants who are more at risk of contracting severe rotavirus gastroenteritis and nosocomial RV infection.
Collapse
Affiliation(s)
- Claudio Costantino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties (PROMISE) "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy
| | - Arianna Conforto
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties (PROMISE) "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy
| | - Nicole Bonaccorso
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties (PROMISE) "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy
| | - Livia Cimino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties (PROMISE) "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy
| | - Martina Sciortino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties (PROMISE) "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy
| | - Mario Palermo
- Regional Health Authority of Sicily, Via Vaccaro 5, 90145 Palermo, Italy
| | - Kim Maiolo
- Neonatal Intensive Care Unit, Garibaldi Hospital, 95124 Catania, Italy
| | | | - Pasqua Maria Betta
- Neonatal Intensive Care Unit, University Hospital of Catania (G. Rodolico), 90123 Catania, Italy
| | - Mariacarmela Caracciolo
- Neonatal Intensive Care Unit, University Hospital of Catania (G. Rodolico), 90123 Catania, Italy
| | - Carmine Mattia Loretta
- Neonatal Intensive Care Unit, University Hospital of Catania (G. Rodolico), 90123 Catania, Italy
| | - Alessandro Arco
- Neonatal Intensive Care Unit, University Hospital of Messina, 98124 Messina, Italy
| | - Eloisa Gitto
- Neonatal Intensive Care Unit, University Hospital of Messina, 98124 Messina, Italy
| | | | - Domenica Mancuso
- Neonatology Unit, NICU and Creche, ARNAS Civico, 90127 Palermo, Italy
| | - Giuliana Vitaliti
- Neonatology Unit, NICU and Creche, ARNAS Civico, 90127 Palermo, Italy
| | - Vincenzo Rosella
- Neonatal Intensive Care Unit, Maternal and Child Department, Buccheri La Ferla Fatebenefratelli Hospital, 90123 Palermo, Italy
| | - Giuseppa Pinello
- Neonatal Intensive Care Unit, Maternal and Child Department, Buccheri La Ferla Fatebenefratelli Hospital, 90123 Palermo, Italy
| | - Giovanni Corsello
- Neonatology and Neonatal Intensive Care Unit, University Hospital of Palermo (P. Giaccone), 90127 Palermo, Italy
| | - Gregorio Serra
- Neonatology and Neonatal Intensive Care Unit, University Hospital of Palermo (P. Giaccone), 90127 Palermo, Italy
| | - Bruna Gabriele
- Neonatology and Neonatal Intensive Care Unit, University Hospital of Palermo (P. Giaccone), 90127 Palermo, Italy
| | - Fabio Tramuto
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties (PROMISE) "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy
| | - Vincenzo Restivo
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties (PROMISE) "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy
| | - Emanuele Amodio
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties (PROMISE) "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy
| | - Francesco Vitale
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties (PROMISE) "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy
| |
Collapse
|
4
|
Elia S, Moore Y, Duke T, Crawford NW, Tosif S. Influenza vaccine administration in a paediatric intensive care unit. J Paediatr Child Health 2022; 58:1766-1770. [PMID: 35748619 DOI: 10.1111/jpc.16083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 04/28/2022] [Accepted: 05/02/2022] [Indexed: 11/27/2022]
Abstract
AIM We describe the clinical profile of children and outcomes of influenza immunisation for patients in a paediatric intensive care unit (PICU). METHODS Over two influenza seasons: 19/04/2018 to 07/08/2018 and 02/05/2019 to 10/10/2019, an immunisation nurse and PICU nurse coordinator met weekly and identified patients to receive the influenza vaccine. An inpatient list of PICU patients was screened for eligible patients: greater than 6 months of age, did not have imminent procedures (e.g. surgery) or were not critically unwell, as determined by the treating team, to receive the influenza vaccine. Patients were excluded if they had undergone surgery in the previous 24 hours or were being treated palliatively. RESULTS Sixty patients in PICU were identified, with 43% (26/60) receiving the vaccine while in PICU and 17% (10/60) once discharged from PICU to the general ward environment. The majority of patients immunised were in PICU due to cardiac surgery/cardiology or general medical conditions, such as cerebral palsy or RSV bronchiolitis. There were no reported adverse events following immunisation. CONCLUSIONS We have demonstrated the suitability and acceptability of children in the PICU receiving the seasonal influenza vaccine and tailored interventions to follow-up once discharged from PICU to optimise protection.
Collapse
Affiliation(s)
- Sonja Elia
- Immunisation Services, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Yvette Moore
- Paediatric Intensive Care Unit, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Trevor Duke
- Paediatric Intensive Care Unit, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Nigel W Crawford
- Immunisation Services, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Shidan Tosif
- Immunisation Services, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
5
|
Positive Patient Postoperative Outcomes with Pharmacotherapy: A Narrative Review including Perioperative-Specialty Pharmacist Interviews. J Clin Med 2022; 11:jcm11195628. [PMID: 36233497 PMCID: PMC9572852 DOI: 10.3390/jcm11195628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/15/2022] [Accepted: 09/21/2022] [Indexed: 11/19/2022] Open
Abstract
The influence of pharmacotherapy regimens on surgical patient outcomes is increasingly appreciated in the era of enhanced recovery protocols and institutional focus on reducing postoperative complications. Specifics related to medication selection, dosing, frequency of administration, and duration of therapy are evolving to optimize pharmacotherapeutic regimens for many enhanced recovery protocolized elements. This review provides a summary of recent pharmacotherapeutic strategies, including those configured within electronic health record (EHR) applications and functionalities, that are associated with the minimization of the frequency and severity of postoperative complications (POCs), shortened hospital length of stay (LOS), reduced readmission rates, and cost or revenue impacts. Further, it will highlight preventive pharmacotherapy regimens that are correlated with improved patient preparation, especially those related to surgical site infection (SSI), venous thromboembolism (VTE), nausea and vomiting (PONV), postoperative ileus (POI), and emergence delirium (PoD) as well as less commonly encountered POCs such as acute kidney injury (AKI) and atrial fibrillation (AF). The importance of interprofessional collaboration in all periprocedural phases, focusing on medication management through shared responsibilities for drug therapy outcomes, will be emphasized. Finally, examples of collaborative care through shared mental models of drug stewardship and non-medical practice agreements to improve operative throughput, reduce operative stress, and increase patient satisfaction are illustrated.
Collapse
|
6
|
Schollin Ask L, Wingren L, Storsaeter J. National guidelines recommend rotavirus vaccination to inpatient preterm infants. Acta Paediatr 2021; 110:2680-2685. [PMID: 34091936 DOI: 10.1111/apa.15968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/27/2021] [Accepted: 06/02/2021] [Indexed: 01/31/2023]
Abstract
AIM The aim was to perform a literature search of the latest evidence of administration of dose 1 of rotavirus vaccine to children admitted in neonatal intensive care or special care unit settings. METHODS The literature search focused on the outcome of serious adverse events of rotavirus vaccination in vaccinated children and on possible symptomatic infection in controls and in unvaccinated children via transmission of the vaccine virus in the same ward. Results and guidelines were discussed with a working group selected from the national advisory group of child health. Also, a survey to neonatal care units in Sweden was sent out due to the subject. RESULTS Administration of rotavirus vaccine is safe for age-eligible preterm children and unvaccinated children in the same ward. A satisfactory immune response has been shown, and basic hygiene routines are enough. Also, hospitalised age-eligible children with paediatric surgical conditions should be considered the rotavirus vaccine. CONCLUSION The Swedish Public Health Agency recommends that preterm infants as well as children who are admitted for other reasons in the neonatal ward be vaccinated with dose 1 against rotavirus infection when hospitalised and when age eligible.
Collapse
Affiliation(s)
| | - Lisen Wingren
- Sachsska Children and Youth Hospital Stockholm Sweden
| | | |
Collapse
|
7
|
Abstract
Premature infants admitted to the neonatal intensive care unit are at risk for severe infections and infectious complications caused by vaccine-preventable diseases. Both maternal and neonatal vaccination prevent such infections and improve outcomes for premature infants. An understanding of vaccine efficacy, safety, and administration recommendations, as well as reasons for vaccine hesitancy among clinicians and caregivers, facilitate strategies for improving vaccination rates for infants in the neonatal intensive care unit. Timely vaccination of premature infants confers important protection and improves vaccination rates during childhood.
Collapse
Affiliation(s)
- Dustin D Flannery
- Department of Pediatrics, Newborn care at Pennsylvania Hospital, 800 Spruce Street, Philadelphia, PA 19107, USA; Division of Neonatology, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA
| | - Kelly C Wade
- Department of Pediatrics, Newborn care at Pennsylvania Hospital, 800 Spruce Street, Philadelphia, PA 19107, USA; Division of Neonatology, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA.
| |
Collapse
|
8
|
Briggs-Steinberg C, Aboudi D, Hodson G, Shah S. Clinical Tolerance of In-Neonatal Intensive Care Unit Administration of Rotavirus Vaccine. Am J Perinatol 2021; 38:456-462. [PMID: 31739360 DOI: 10.1055/s-0039-1698455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE This article determines the tolerance of neonatal intensive care unit (NICU)-based administration of RV5 in premature infants. This article also aims to compare the rate of clinically significant adverse events after RV5 immunization to the standard 2-month shot series and to historical controls who were not immunized. STUDY DESIGN This is a retrospective case-control study of 201 premature infants immunized with RV5. Infants were evaluated for clinically significant events 7 days before and after immunization and were compared with events after the 2-month shot series and to 189 historical controls. Wilcoxon signed rank test and McNemar's test were used for all paired analysis. RESULTS There was no increase in number of infants with clinically significant adverse events when comparing after RV5 to prior to RV5, after the 2-month shot series, or to the historical controls. CONCLUSION RV5 is well tolerated in premature infants and does not result in clinically significant adverse events when administered in NICU-hospitalized infants.
Collapse
Affiliation(s)
- Courtney Briggs-Steinberg
- Division of Neonatology, Department of Pediatrics, Staten Island University Hospital, Northwell Health, Staten Island, New York.,Department of Pediatrics, Zucker School of Medicine at Hofstra/Northwell, Staten Island, New York
| | - David Aboudi
- Division of Newborn Medicine, Department of Pediatrics, Maria Fareri Children's Hospital at Westchester Medical Center, New York Medical College, Valhalla, New York
| | - Gabrielle Hodson
- Department of Pharmacy, Maria Fareri Children's Hospital at Westchester Medical Center, New York Medical College, Valhalla, New York
| | - Shetal Shah
- Division of Newborn Medicine, Department of Pediatrics, Maria Fareri Children's Hospital at Westchester Medical Center, New York Medical College, Valhalla, New York
| |
Collapse
|
9
|
Shane AL, Weinberg GA. Can We Further Increase Protection Against Rotavirus by Reducing 2 Barriers to Immunization, Inpatient Hospitalization and Older Age? J Pediatric Infect Dis Soc 2021; 10:68-70. [PMID: 31318433 DOI: 10.1093/jpids/piz046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 06/06/2019] [Indexed: 11/13/2022]
Affiliation(s)
- Andi L Shane
- Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Georgia
| | - Geoffrey A Weinberg
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, New York
| |
Collapse
|
10
|
Burke RM, Tate JE, Han GS, Quenelle R, Gautam R, Wadford DA, Bowen MD, Parashar UD. Rotavirus Vaccination Coverage During a Rotavirus Outbreak Resulting in a Fatality at a Subacute Care Facility. J Pediatric Infect Dis Soc 2020; 9:287-292. [PMID: 31318031 PMCID: PMC6980350 DOI: 10.1093/jpids/piz015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 02/05/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND The introduction of rotavirus vaccine in the United States has reduced rotavirus disease burden, but outbreaks still occur. Complete-series rotavirus vaccination coverage is <75% in the United States, and it might be lower among vulnerable populations. We describe here the clinical characteristics and vaccination status of children during a rotavirus outbreak in a pediatric subacute care facility in 2017. METHODS Clinical history, signs and symptoms, and vaccination history were abstracted for the 26 patients residing in the facility during the time of the outbreak. A case-patient was defined as one who experienced 3 or more loose stools in a period of 24 hours with onset between April 17 and May 17, 2017. Stool samples from 14 resident patients were tested for rotavirus with reverse-transcription polymerase chain reaction. RESULTS The median patient age at the facility was 2.9 years. Of the 26 resident patients, 22 (85%) met the case definition. One child died. Stool samples from 11 case-patients were positive according to reverse-transcription polymerase chain reaction for rotavirus. Fifteen case-patients were unvaccinated against rotavirus; 3 were partially vaccinated, and 2 were fully vaccinated. Vaccination status could not be completely determined in 2 cases. CONCLUSIONS An outbreak of rotavirus affected nearly all resident patients of a subacute care facility and caused 1 death. Because of recommendations against giving rotavirus vaccine in an intensive care setting, infants who require a prolonged intensive care stay might age out of rotavirus vaccine eligibility (the first dose must be given before 15 weeks of age according to Advisory Committee on Immunization Practices recommendations). The result is a vulnerable population of unvaccinated infants who might later congregate in another care setting.
Collapse
Affiliation(s)
- Rachel M. Burke
- Viral Gastroenteritis Branch, Division of Viral Diseases, Centers for Disease Control and Prevention; Atlanta, GA, USA;,Epidemic Intelligence Service, Centers for Disease Control and Prevention; Atlanta, GA, USA
| | - Jacqueline E. Tate
- Viral Gastroenteritis Branch, Division of Viral Diseases, Centers for Disease Control and Prevention; Atlanta, GA, USA
| | - George S. Han
- Santa Clara County Public Health Department, San Jose, CA, USA
| | | | - Rashi Gautam
- IHRC Inc., Contracting Agency to the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Debra A. Wadford
- California Department of Public Health Viral and Rickettsial Disease Laboratory, Richmond, CA, USA
| | - Michael D. Bowen
- Viral Gastroenteritis Branch, Division of Viral Diseases, Centers for Disease Control and Prevention; Atlanta, GA, USA
| | - Umesh D. Parashar
- Viral Gastroenteritis Branch, Division of Viral Diseases, Centers for Disease Control and Prevention; Atlanta, GA, USA
| |
Collapse
|
11
|
Gower CM, Dunning J, Nawaz S, Allen D, Ramsay ME, Ladhani S. Vaccine-derived rotavirus strains in infants in England. Arch Dis Child 2020; 105:553-557. [PMID: 31871043 DOI: 10.1136/archdischild-2019-317428] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 12/02/2019] [Accepted: 12/03/2019] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To describe infants with acute gastroenteritis symptoms in primary and secondary care who have the Rotarix vaccine-derived G1P[8] rotavirus strain identified in their stools. DESIGN This is a prospective national surveillance conducted by Public Health England (PHE). Rotavirus-positive samples from vaccine-eligible children are routinely submitted to PHE for confirmation, and general practitioners are requested to complete a surveillance questionnaire for all cases. The modified Vesikari Score was used to assess severity of gastroenteritis. SETTING England, July 2013-September 2016. RESULTS 2637 rotavirus strains were genotyped and 215 (8%) identified as the Rotarix vaccine-derived G1P[8] strain. There were no Rotarix vaccine-derived G1P[8] strains detected in unimmunised infants. Rotarix vaccine-derived G1P[8] strains clustered around the time of rotavirus vaccination and were responsible for 82% (107 of 130) of rotavirus-positive samples in 2-month-old infants and 68% (36 of 53) in 3-month-old infants. However, 13 samples were obtained more than 7 weeks after the last vaccination date; 10 of these specimens were from six children who were subsequently diagnosed with severe combined immunodeficiency (SCID). Diarrhoea was the single most common presenting symptom (83.0%) in infants with Rotarix vaccine-derived G1P[8] strains, who were less likely to present with fever, vomiting, dehydration or severe gastroenteritis than infants with wild-type rotavirus infection. CONCLUSIONS Rotavirus identified in stools of infants around the time of their routine immunisations is most likely the Rotarix vaccine-derived G1P[8] strain. Infants with undiagnosed SCID at the time of rotavirus immunisation may experience prolonged gastroenteritis symptoms. Most infants with vaccine strains in their stools more than 7 weeks after immunisation had SCID.
Collapse
Affiliation(s)
- Charlotte Mary Gower
- Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, UK
| | - Jake Dunning
- Tuberculosis; Acute Respiratory, Gastrointestinal, Emerging and Zoonotic Infections; and Travel and Migrant Health Division (TARGET), National Infection Service, Public Health England, London, UK.,Enteric Virus Unit, Virus Reference Department, National Infection Service Laboratories, Public Health England, London, UK
| | - Sameena Nawaz
- Enteric Virus Unit, Virus Reference Department, National Infection Service Laboratories, Public Health England, London, UK
| | - David Allen
- Enteric Virus Unit, Virus Reference Department, National Infection Service Laboratories, Public Health England, London, UK.,Department of Pathogen Molecular Biology, London School of Hygiene and Tropical Medicine, London, UK
| | - Mary Elizabeth Ramsay
- Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, UK
| | - Shamez Ladhani
- Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, UK .,Paediatric Infectious Disease Research Group, St George's, University of London, London, UK
| |
Collapse
|
12
|
Rotavirus vaccination in the neonatal intensive care units: where are we? A rapid review of recent evidence. Curr Opin Pediatr 2020; 32:167-191. [PMID: 31851055 DOI: 10.1097/mop.0000000000000869] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Rotavirus is a leading cause of viral acute gastroenteritis in infants. Neonates hospitalized in neonatal intensive care units (NICUs) are at risk of rotavirus infections with severe outcomes. The administration of rotavirus vaccines is only recommended, in the United States and Canada, upon discharge from the NICU despite rotavirus vaccines being proven well tolerated and effective in these populations, because of risks of live-attenuated vaccine administration in immunocompromised patients and theoretical risks of rotavirus vaccine strains shedding and transmission.We aimed to summarize recent evidence regarding rotavirus vaccine administration in the NICU setting and safety of rotavirus vaccines in preterm infants. METHODS We conducted a rapid review of the literature from the past 10 years, searching Medline and Embase, including all study types except reviews, reporting on rotavirus vaccines 1 and 5; NICU setting; shedding or transmission; safety in preterm. One reviewer performed data extraction and quality assessment. RECENT FINDINGS Thirty-one articles were analyzed. Vaccine-derived virus shedding following rotavirus vaccines existed for nearly all infants, mostly during the first week after dose 1, but with rare transmission only described in the household setting. No case of transmission in the NICU was reported. Adverse events were mild to moderate, occurring in 10-60% of vaccinated infants. Extreme premature infants or those with underlying gastrointestinal failure requiring surgery presented with more severe adverse events. SUMMARY Recommendations regarding rotavirus vaccine administration in the NICU should be reassessed in light of the relative safety and absence of transmission of rotavirus vaccine strains in the NICU.
Collapse
|
13
|
Sioriki AA, Gkentzi D, Papadimitriou E, Dimitriou G, Karatza A. Vaccinations in Infants Born Preterm: An Update. Curr Pediatr Rev 2020; 16:148-155. [PMID: 31951184 DOI: 10.2174/1573396316666200116094459] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 08/25/2019] [Accepted: 12/16/2019] [Indexed: 02/08/2023]
Abstract
Infants born prematurely (before completion of 37 weeks of gestation) are at increased risk of morbidity and mortality due to vaccine preventable diseases, mostly because of their immunological immaturity and failure of transfer of maternal protective antibodies. Despite their great need of being vaccinated, concerns on vaccine safety and efficacy, constitute the main reasons for which vaccinations are often delayed in this group. In this review we summarize the latest evidence on vaccine safety, efficacy and immunogenicity in preterm infants which is similar to full-term infants. Therefore there is no reason for delaying vaccination in this population.
Collapse
Affiliation(s)
| | - Despoina Gkentzi
- Department of Paediatrics, University Patras Medical School, Patras, Greece
| | | | - Gabriel Dimitriou
- Department of Paediatrics, University Patras Medical School, Patras, Greece
| | - Ageliki Karatza
- Department of Paediatrics, University Patras Medical School, Patras, Greece
| |
Collapse
|
14
|
Álvarez Aldeán J, Ares Segura S, Díaz González C, Montesdeoca Melián A, García Sánchez R, Boix Alonso H, Moreno-Pérez D. Recommendations for vaccination against ROTAvirus in PREMature newborns (ROTAPREM). ANALES DE PEDIATRÍA (ENGLISH EDITION) 2019. [DOI: 10.1016/j.anpede.2019.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
15
|
Recomendaciones para la vacunación frente al ROTAvirus de los recién nacidos PREMaturos (ROTAPREM). An Pediatr (Barc) 2019; 91:205.e1-205.e7. [DOI: 10.1016/j.anpedi.2019.06.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 06/09/2019] [Indexed: 01/26/2023] Open
|
16
|
Hofstetter AM, Jacobson EN, deHart MP, Englund JA. Early Childhood Vaccination Status of Preterm Infants. Pediatrics 2019; 144:peds.2018-3520. [PMID: 31391213 DOI: 10.1542/peds.2018-3520] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/21/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Preterm infants are at increased risk for vaccine-preventable infections and associated complications. Limited studies describe timely vaccination of these vulnerable infants. METHODS This retrospective cohort study included Washington State infants with birth hospitalizations at an urban academic medical center between 2008 and 2013. Demographic, clinical, and visit data from electronic health records were linked to vaccine data from the Washington State Immunization Information System. Completion of the recommended 7-vaccine series by 19 months of age was compared between preterm infants (born at <37 weeks' gestation) and term/postterm infants (born at 37-43 weeks' gestation) by using Pearson's χ2 test and multivariable logistic regression. Secondary outcomes included 7-vaccine series completion by 36 months of age and receipt of individual vaccines in the series. Rotavirus, hepatitis A, and influenza vaccination was also assessed. RESULTS Of study infants (n = 10 367), 19.3% were born prematurely. Preterm infants had lower 7-vaccine series completion compared with term/postterm infants by 19 months (47.5% vs 54.0%; adjusted odds ratio 0.77 [95% confidence interval 0.65-0.90]) and 36 months (63.6% vs 71.3%; adjusted odds ratio 0.73 [95% confidence interval 0.61-0.87]). Early preterm (23-33 weeks' gestation) and late preterm (34-36 weeks' gestation) infants had a lower rate of 7-vaccine series completion compared with term/postterm infants. Full influenza vaccination coverage by 19 months also differed between groups (early preterm: 47.7%; late preterm: 41.5%; term/postterm: 44.7%; P = .02). CONCLUSIONS Over half of preterm infants were undervaccinated at 19 months; one-third failed to catch up by 36 months. Strategies to improve vaccination of these high-risk infants are needed.
Collapse
Affiliation(s)
- Annika M Hofstetter
- Department of Pediatrics, University of Washington, Seattle, Washington; .,Seattle Children's Research Institute, Seattle Children's Hospital, Seattle, Washington; and
| | | | - M Patricia deHart
- Office of Immunization and Child Profile, Washington State Department of Health, Olympia, Washington
| | - Janet A Englund
- Department of Pediatrics, University of Washington, Seattle, Washington.,Seattle Children's Research Institute, Seattle Children's Hospital, Seattle, Washington; and
| |
Collapse
|
17
|
Abstract
Rotavirus (RV) is the leading cause of severe gastroenteritis in young children. However, because the incorporation of live-attenuated RV vaccines as part routine childhood immunization schedules, the rates of hospitalization from RV infections have decreased significantly across the globe. While RV vaccine safety and effectiveness have been well documented in the general population, there is controversy surrounding its use in preterm and immunocompromised infants. In this article, we review current research and consensus statements on the safety of the RV vaccine, the immunogenicity of the response and the potential for transmission and shedding of the virus postvaccination in both preterm infants and immunocompromised infants. RV vaccines are well tolerated in hospitalized preterm infants with no significant increase in nosocomial infections, gastrointestinal complications or feeding difficulties. In select immunocompromised infants (such as HIV-infected or HIV-exposed infants), RV vaccine administration did not increase the rate of adverse events. However, multiple case reports noted increased rates of adverse events in infants with severe combined immunodeficiency. The risk of viral shedding and transmission between vaccinated neonates and household contacts remain low and does not outweigh the benefit of vaccination.
Collapse
|
18
|
Esposito S, Pugni L, Mosca F, Principi N. Rotarix® and RotaTeq® administration to preterm infants in the neonatal intensive care unit: Review of available evidence. Vaccine 2018; 36:5430-5434. [DOI: 10.1016/j.vaccine.2017.10.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 08/19/2017] [Accepted: 10/05/2017] [Indexed: 11/25/2022]
|
19
|
Syed YY, Lyseng-Williamson KA. Pentavalent rotavirus vaccine (RotaTeq®) in the prevention of rotavirus gastroenteritis: a profile of its use in the EU. DRUGS & THERAPY PERSPECTIVES 2018. [DOI: 10.1007/s40267-018-0497-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
20
|
Pahud B, Pallotto EK. Rotavirus Immunization for Hospitalized Infants: Are We There Yet? Pediatrics 2018; 141:peds.2017-3499. [PMID: 29212882 DOI: 10.1542/peds.2017-3499] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/23/2017] [Indexed: 11/24/2022] Open
Affiliation(s)
- Barbara Pahud
- Divisions of Infectious Diseases and .,Department of Pediatrics, University of Missouri-Kansas City, Kansas City, Missouri
| | - Eugenia K Pallotto
- Department of Pediatrics, University of Missouri-Kansas City, Kansas City, Missouri.,Neonatology, Children's Mercy Hospital, Kansas City, Missouri; and
| |
Collapse
|
21
|
Hofstetter AM, Lacombe K, Klein EJ, Jones C, Strelitz B, Jacobson E, Ranade D, Ward ML, Mijatovic-Rustempasic S, Evans D, Wikswo M, Bowen MD, Parashar UD, Payne DC, Englund JA. Risk of Rotavirus Nosocomial Spread After Inpatient Pentavalent Rotavirus Vaccination. Pediatrics 2018; 141:peds.2017-1110. [PMID: 29212881 DOI: 10.1542/peds.2017-1110] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/20/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Infants born prematurely or with underlying conditions are at increased risk of severe rotavirus disease and associated complications. Given the theoretical risk of nosocomial transmission of vaccine-type rotavirus, rotavirus vaccination is recommended for infants at or after discharge from neonatal care settings. Because the first dose should be administered by 104 days of age, some infants may be age-ineligible for vaccination if delayed until discharge. METHODS This prospective cohort included infants admitted to an urban academic medical center between birth and 104 days who received care in intensive care settings. Pentavalent human-bovine reassortant rotavirus vaccine (RV5) was used, per routine clinical care. Stool specimens were collected weekly (February 2013-April 2014) and analyzed for rotavirus strains using real-time reverse transcription-polymerase chain reaction. Demographic and vaccine data were collected. RV5 safety was not assessed. RESULTS Of 385 study infants, 127 were age-eligible for routine vaccinations during hospitalization. At discharge, 32.7% were up-to-date for rotavirus vaccination, compared with 82.7% for other vaccinations. Of rotavirus-unvaccinated infants, 42.6% were discharged at age >104 days and thus vaccination-ineligible. Of 1192 stool specimens collected, rotavirus was detected in 13 (1.1%): 1 wild-type strain from an unvaccinated infant; 12 vaccine-type strains from 9 RV5-vaccinated infants. No vaccine-type rotavirus cases were observed among unvaccinated infants (incidence rate: 0.0 [95% confidence interval: 0.0-1.5] cases per 1000 patient days at risk). CONCLUSIONS These data suggest that delaying rotavirus vaccination until discharge from the hospital could lead to missed vaccination opportunities and may be unnecessary in institutions using RV5 with comparable infection control standards.
Collapse
Affiliation(s)
- Annika M Hofstetter
- Department of Pediatrics, University of Washington, Seattle, Washington; .,Seattle Children's Research Institute, Seattle, Washington; and
| | - Kirsten Lacombe
- Seattle Children's Research Institute, Seattle, Washington; and
| | - Eileen J Klein
- Department of Pediatrics, University of Washington, Seattle, Washington.,Seattle Children's Research Institute, Seattle, Washington; and
| | - Charla Jones
- Seattle Children's Research Institute, Seattle, Washington; and
| | - Bonnie Strelitz
- Seattle Children's Research Institute, Seattle, Washington; and
| | - Elizabeth Jacobson
- Department of Pediatrics, University of Washington, Seattle, Washington.,Seattle Children's Research Institute, Seattle, Washington; and
| | - Daksha Ranade
- Seattle Children's Research Institute, Seattle, Washington; and
| | - M Leanne Ward
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Slavica Mijatovic-Rustempasic
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Diana Evans
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mary Wikswo
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Michael D Bowen
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Umesh D Parashar
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Daniel C Payne
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Janet A Englund
- Department of Pediatrics, University of Washington, Seattle, Washington.,Seattle Children's Research Institute, Seattle, Washington; and
| |
Collapse
|
22
|
Hiramatsu H, Suzuki R, Nagatani A, Boda H, Miyata M, Hattori F, Miura H, Sugata K, Yamada S, Komoto S, Taniguchi K, Ihira M, Nishimura N, Ozaki T, Yoshikawa T. Rotavirus Vaccination Can Be Performed Without Viral Dissemination in the Neonatal Intensive Care Unit. J Infect Dis 2017; 217:589-596. [DOI: 10.1093/infdis/jix590] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 11/10/2017] [Indexed: 11/13/2022] Open
|
23
|
Gad A, Parkinson E, Khawar N, Elmeki A, Narula P, Hoang D. Perspectives and attitudes of pediatricians concerning post-discharge care practice of premature infants. J Neonatal Perinatal Med 2017; 10:99-107. [PMID: 28304316 DOI: 10.3233/npm-1615] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Survival rates of premature infants are at a historical high and increasingly more pediatricians are caring for former premature infants. The goal of this study was to describe the perspectives and attitudes of pediatricians, as well as, the challenges of rendering post-neonatal intensive care unit (NICU) discharge care for premature infants. METHODS An anonymous 22-question web-based survey was emailed to pediatricians who are current members of the American Academy of Pediatrics (AAP) and practicing in Kings County, New York. RESULTS There were 148 completed surveys with 79% being general pediatricians. Of all respondents, 63% believed that premature infants should have a neonatal high risk follow-up visit within days after discharge and 64% were satisfied with the NICU discharge summary acquisition. While 74% of pediatricians felt comfortable following up with former extremely premature infants, 65% referred to specialists, most often to child development, neurology, and physical and/or occupational therapy. The majority (85%) were more likely to refer premature infants to early intervention. Participating pediatricians varied in their knowledge of immunization and breastfeeding guidelines. Finally, 88% of respondents acknowledged that caregivers of premature infants experience increased stress, with 53% stating that the stress should be addressed. CONCLUSIONS Understanding the perceptions and challenges of pediatricians who care for premature infants may help improve post NICU quality of care. Transition to the outpatient setting is a crucial step in the management of premature infants and a focus on improved hand-off procedures between hospital and physicians may prove beneficial. Also, pediatricians must stay abreast of current recommendations for breastfeeding and vaccinations. Furthermore, emphasis should be given to stress reduction and management for caregivers of former premature infants.
Collapse
|
24
|
Abstract
The present statement provides information concerning the clinical rotavirus disease and rotavirus vaccines in Canada. Since the implementation of publically funded rotavirus vaccine programs in Canada, increasing evidence has been accumulating globally as to the effectiveness of rotavirus vaccines in the prevention of acute gastroenteritis. Current data estimate vaccine effectiveness to be in the order of 85% for preventing severe disease, including hospitalizations and emergency department visits, when vaccine coverage is high. Also, substantial herd protection in older children has been documented. Post-marketing surveillance has detected a very small increased risk of intussusception (one to three per 100,000) in children, usually occurring within 1 week of vaccination. Infants who have an identified significant immune deficiency or are suspected of having such a condition should not receive rotavirus vaccine.
Collapse
Affiliation(s)
- Nicole Le Saux
- Canadian Paediatric Society, Infectious Diseases and Immunization Committee, Ottawa, Ontario
| |
Collapse
|
25
|
Le Saux N. Recommandations sur l’utilisation du vaccin antirotavirus chez les nourrissons. Paediatr Child Health 2017. [DOI: 10.1093/pch/pxx071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
26
|
Kim JS, Kim SM, Kim HS. High Prevalence of Rotavirus G4P[6] Genotypes among Neonates in Two Korean Hospitals. ANNALS OF CLINICAL MICROBIOLOGY 2017. [DOI: 10.5145/acm.2017.20.3.63] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Jae-Seok Kim
- Department of Laboratory Medicine, Hallym University College of Medicine, Hwaseong, Korea
| | - Sung Mi Kim
- Department of Pediatrics, Busan Saint Mary Hospital, Busan, Korea
| | - Hyun Soo Kim
- Department of Laboratory Medicine, Hallym University College of Medicine, Hwaseong, Korea
| |
Collapse
|
27
|
Doherty M, Schmidt-Ott R, Santos JI, Stanberry LR, Hofstetter AM, Rosenthal SL, Cunningham AL. Vaccination of special populations: Protecting the vulnerable. Vaccine 2016; 34:6681-6690. [PMID: 27876197 DOI: 10.1016/j.vaccine.2016.11.015] [Citation(s) in RCA: 120] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 10/12/2016] [Accepted: 11/07/2016] [Indexed: 02/07/2023]
Abstract
One of the strategic objectives of the 2011-2020 Global Vaccine Action Plan is for the benefits of immunisation to be equitably extended to all people. This approach encompasses special groups at increased risk of vaccine-preventable diseases, such as preterm infants and pregnant women, as well as those with chronic and immune-compromising medical conditions or at increased risk of disease due to immunosenescence. Despite demonstrations of effectiveness and safety, vaccine uptake in these special groups is frequently lower than expected, even in developed countries with vaccination strategies in place. For example, uptake of the influenza vaccine in pregnancy rarely exceeds 50% in developed countries and, although data are scarce, it appears that only half of preterm infants are up-to-date with routine paediatric vaccinations. Many people with chronic medical conditions or who are immunocompromised due to disease or aging are also under-vaccinated. In the US, coverage among people aged 65years or older was 67% for the influenza vaccine in the 2014-2015 season and 55-60% for tetanus and pneumococcal vaccines in 2013, while the coverage rate for herpes zoster vaccination among those aged 60years or older was only 24%. In most other countries, rates are far lower. Reasons for under-vaccination of special groups include fear of adverse outcomes or illness caused by the vaccine, the inconvenience (and in some settings, cost) of vaccination and lack of awareness of the need for vaccination or national recommendations. There is also evidence that healthcare providers' attitudes towards vaccination are among the most important influences on the decision to vaccinate. It is clear that physicians' adherence to recommendations needs to be improved, particularly where patients receive care from multiple subspecialists and receive little or no care from primary care providers.
Collapse
Affiliation(s)
- Mark Doherty
- GSK Vaccines, Avenue Fleming 20, Parc de la Noire Epine, B-1300 Wavre, Belgium.
| | | | | | - Lawrence R Stanberry
- Columbia University College of Physicians and Surgeons, New York, NY, USA; New York-Presbyterian/Morgan Stanley Children's Hospital, New York, NY, USA.
| | - Annika M Hofstetter
- Department of Pediatrics, University of Washington, Seattle, WA, USA; Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA, USA.
| | - Susan L Rosenthal
- Columbia University College of Physicians and Surgeons, New York, NY, USA.
| | - Anthony L Cunningham
- Westmead Institute, The Centre for Virus Research, 176 Hawkesbury Road, NSW 2145, Australia.
| |
Collapse
|
28
|
Marinosci A, Doit C, Koehl B, Belhacel K, Mariani Kurkdjian P, Melki I, Renaud A, Lemaitre C, Ammar Khodja N, Blachier A, Bonacorsi S, Faye A, Lorrot M. [Nosocomial rotavirus gastroenteritis]. Arch Pediatr 2016; 23:1118-1123. [PMID: 27642146 DOI: 10.1016/j.arcped.2016.07.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 06/22/2016] [Accepted: 07/07/2016] [Indexed: 11/16/2022]
Abstract
Rotavirus is the most common cause of gastroenteritis in children requiring hospitalization. It is a very resistant and contagious virus causing nosocomial gastroenteritis. In France, the vaccine against rotavirus has been available since 2006, but the vaccine is not recommended for infant vaccination. The aim of this retrospective study was to describe nosocomial rotavirus gastroenteritis (NRGE) and to assess its impact on children hospitalized in the General Pediatrics Department of Robert-Debré Hospital (Paris) between 1 January 2009 and 31 December 2013. We analyzed the demographic characteristics of children (age, term birth, underlying diseases) and the severity of the NRGE (oral or intravenous hydration), and assessed whether these children could benefit from vaccination against rotavirus. RESULTS One hundred thirty-six children presented nosocomial rotavirus infection, with an incidence of 2.5 NRGE per 1000 days of hospitalization. The incidence of NRGE was stable between 2009 and 2013 despite the introduction of specific hygiene measures. The average age of the children was 7 months (range: 0.5-111 months). Most often NRGE occurred in children hospitalized for respiratory diseases (65% of cases) and requiring prolonged hospitalization (median: 18 days). One-third of children were born premature (25%). Hydration was oral in 80 patients (59%), by intravenous infusion in 18 patients (13%), and intraosseous in one patient. Half of the patients were aged less than 5 months and could benefit from the protection afforded by vaccination. CONCLUSION NRGE are common. Rotavirus mass vaccination should have a positive impact on the incidence of NRGE by reducing the number of children hospitalized for gastroenteritis, therefore indirectly reducing the number of hospital cross-infections of hospitalized children who are too young to be vaccinated.
Collapse
Affiliation(s)
- A Marinosci
- Service de pédiatrie générale, hôpital Robert-Debré, AP-HP, 75019 Paris, France
| | - C Doit
- Service de microbiologie, hôpital Robert-Debré, AP-HP, 75019 Paris, France; Équipe d'hygiène hospitalière, hôpital Robert-Debré, AP-HP, 75019 Paris, France
| | - B Koehl
- Service de pédiatrie générale, hôpital Robert-Debré, AP-HP, 75019 Paris, France; Université Paris Diderot, Paris 7, 75019 Paris, France
| | - K Belhacel
- Équipe d'hygiène hospitalière, hôpital Robert-Debré, AP-HP, 75019 Paris, France
| | | | - I Melki
- Service de pédiatrie générale, hôpital Robert-Debré, AP-HP, 75019 Paris, France; Université Paris Diderot, Paris 7, 75019 Paris, France
| | - A Renaud
- Service de pédiatrie générale, hôpital Robert-Debré, AP-HP, 75019 Paris, France
| | - C Lemaitre
- Service de pédiatrie générale, hôpital Robert-Debré, AP-HP, 75019 Paris, France; Université Paris Diderot, Paris 7, 75019 Paris, France
| | - N Ammar Khodja
- Équipe d'hygiène hospitalière, hôpital Robert-Debré, AP-HP, 75019 Paris, France
| | - A Blachier
- Département d'informatique médical (DIM), hôpital Robert-Debré, AP-HP, 75019 Paris, France
| | - S Bonacorsi
- Service de microbiologie, hôpital Robert-Debré, AP-HP, 75019 Paris, France; Université Paris Diderot, Paris 7, 75019 Paris, France; Inserm, IAME, UMR 1137, 75018 Paris, France
| | - A Faye
- Service de pédiatrie générale, hôpital Robert-Debré, AP-HP, 75019 Paris, France; Université Paris Diderot, Paris 7, 75019 Paris, France; Inserm, ECEVE UMRS 1123, 75019 Paris, France
| | - M Lorrot
- Service de pédiatrie générale, hôpital Robert-Debré, AP-HP, 75019 Paris, France; Université Paris Diderot, Paris 7, 75019 Paris, France; Inserm, ECEVE UMRS 1123, 75019 Paris, France.
| |
Collapse
|
29
|
Kilich E, Sadarangani M. Use of rotavirus vaccines in preterm babies on the neonatal unit. Expert Rev Vaccines 2016; 15:1463-1465. [DOI: 10.1080/14760584.2016.1216318] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Eliz Kilich
- Guy’s and St Thomas’ NHS Foundation Trust, Guy’s Hospital, London, UK
| | - Manish Sadarangani
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Children’s Hospital, Oxford, UK
| |
Collapse
|
30
|
Aliabadi N, Tate JE, Parashar UD. Potential safety issues and other factors that may affect the introduction and uptake of rotavirus vaccines. Clin Microbiol Infect 2016; 22 Suppl 5:S128-S135. [PMID: 27129416 DOI: 10.1016/j.cmi.2016.03.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 02/22/2016] [Accepted: 03/13/2016] [Indexed: 10/21/2022]
Abstract
Rotavirus vaccines have demonstrated significant impact in reducing the burden of morbidity and mortality from childhood diarrhoea in countries that have implemented routine vaccination to date. Despite this success, in many countries, rotavirus vaccine coverage remains lower than that of other routine childhood vaccines. Several issues may potentially affect vaccine uptake, namely safety concerns related to intussusception with consequent age restrictions on rotavirus vaccination, contamination with porcine circovirus, vaccine-derived reassortant strains and hospitalization in newborn nurseries at time of administration of live oral rotavirus vaccine. In addition to these safety concerns, other factors may also affect uptake, including lower vaccine efficacy in the developing world, potential emergence of strains escaping from vaccine protection resulting in lower overall impact of a vaccination programme and sustainable vaccine financing. Although further work is needed to address some of these concerns, global policy bodies have reaffirmed that the benefits of rotavirus vaccination outweigh the risks, and vaccine use is recommended globally.
Collapse
Affiliation(s)
- N Aliabadi
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - J E Tate
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - U D Parashar
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| |
Collapse
|
31
|
Thrall S, Doll MK, Nhan C, Gonzales M, Perreault T, Lamer P, Quach C. Evaluation of pentavalent rotavirus vaccination in neonatal intensive care units. Vaccine 2015; 33:5095-102. [DOI: 10.1016/j.vaccine.2015.08.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 08/04/2015] [Accepted: 08/05/2015] [Indexed: 01/02/2023]
|
32
|
Rotavirus-Impfung von Früh- und Neugeborenen im stationären Umfeld. Monatsschr Kinderheilkd 2015. [DOI: 10.1007/s00112-014-3304-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|