Intussusception after Rotavirus Vaccine Introduction in India

BACKGROUND

A three-dose, oral rotavirus vaccine (Rotavac) was introduced in the universal immunization program in India in 2016. A prelicensure trial involving 6799 infants was not large enough to detect a small increased risk of intussusception. Postmarketing surveillance data would be useful in assessing whether the risk of intussusception would be similar to the risk seen with different rotavirus vaccines used in other countries.

METHODS

We conducted a multicenter, hospital-based, active surveillance study at 27 hospitals in India. Infants meeting the Brighton level 1 criteria of radiologic or surgical confirmation of intussusception were enrolled, and rotavirus vaccination was ascertained by means of vaccination records. The relative incidence (incidence during the risk window vs. all other times) of intussusception among infants 28 to 365 days of age within risk windows of 1 to 7 days, 8 to 21 days, and 1 to 21 days after vaccination was evaluated by means of a self-controlled case-series analysis. For a subgroup of patients, a matched case-control analysis was performed, with matching for age, sex, and location.

RESULTS

From April 2016 through June 2019, a total of 970 infants with intussusception were enrolled, and 589 infants who were 28 to 365 days of age were included in the self-controlled case-series analysis. The relative incidence of intussusception after the first dose was 0.83 (95% confidence interval [CI], 0.00 to 3.00) in the 1-to-7-day risk window and 0.35 (95% CI, 0.00 to 1.09) in the 8-to-21-day risk window. Similar results were observed after the second dose (relative incidence, 0.86 [95% CI, 0.20 to 2.15] and 1.23 [95% CI, 0.60 to 2.10] in the respective risk windows) and after the third dose (relative incidence, 1.65 [95% CI, 0.82 to 2.64] and 1.08 [95% CI, 0.69 to 1.73], respectively). No increase in intussusception risk was found in the case-control analysis.

CONCLUSIONS

The rotavirus vaccine produced in India that we evaluated was not associated with intussusception in Indian infants. (Funded by the Bill and Melinda Gates Foundation and others.).

Synthesis of branched, nano channeled, ultrafine and nano carbon tubes from PET wastes using the arc discharge method

Upcycling polymer wastes into useful, and valuable carbon based materials, is a challenging process. We report a novel catalyst-free and solvent-free technique for the formation of nano channeled ultrafine carbon tubes (NCUFCTs) and multiwalled carbon nanotubes (MWCNTs) from polyethylene terephthalate (PET) wastes, using rotating cathode arc discharge technique. The soot obtain from the anode contains ultrafine and nano-sized solid carbon spheres (SCS) with a mean diameter of 221 nm and 100 nm, respectively, formed at the lower temperature region of the anode where the temperature is approximately 1700°C. The carbon spheres are converted into long "Y" type branched and non-branched NCUFCTs and MWCNTs at higher temperature regions where the temperature is approximately 2600°C, with mean diameters of 364 nm and 95 nm, respectively. Soot deposited on the cathode is composed of MWCNTs with a mean diameter of 20 nm and other nanoparticles. The tubular structures present in the anode are longer, bent and often coiled with lesser graphitization compared to the nanotubes in the soot on the cathode.