SAN FRANCISCO – No cases of health care-related gastroenteritis caused by rotavirus occurred in two neonatal intensive care units after implementation of a rotavirus vaccination program in a study presented at ID Week 2013.
The researchers evaluated 103 infants treated at two NICUs in Canada who each received one or more doses of the RV5 vaccine between July 2011 and March 2013. Incidence of health care-associated gastroenteritis caused by rotavirus (HA-RVGE) since surveillance began in 2009 was identified at both facilities, and HA-RVGE prevalence before and after implementation of the RV vaccination program was compared.
“Currently, RV vaccination of infants in the NICU is not recommended due to the theoretical risk of transmission of the vaccine strain within the unit,” researcher Caroline Quach, MD, MSc, division of infectious diseases in the pediatrics department at The Montreal Children’s Hospital, told Healio.com. “Infants in the NICU are, however, at very high risk of complications related to RVGE, mainly once discharged from the NICU, and most will exceed age-eligibility for the first vaccine dose before being discharged.”
Among 36 randomly selected charts that had been reviewed as of the presentation, 60% of patients were males, with a median gestational age of 29 weeks and 5 days and a median birth weight of 1,220 grams. Patients had their first dose at a median age of 60 days, with the second dose administered a median of 36.5 days later (range 23-77 days), and had a median NICU stay of 82 days. Vaccine recipients comprised 14.2% of all NICU admissions within the study period.
No cases of health-care-associated RVGE occurred after initiation of the vaccination program, compared with seven cases before the program.
“There has been no HA-RVGE case since the start of RV vaccination in our NICUs, and it is really because of close collaboration between the NICU leadership, pharmacy and infection control that such a program was possible,” the researchers wrote. “This study provides evidence for the safety of an RV vaccination program in NICUs and, in our setting, benefits outweighed risk of transmission.” Quach added that the pilot study has already allowed for more permissive Canadian recommendations regarding RV vaccination in NICUs.
Disclosure: Quach reports serving as grant investigator and receiving research grants from Merck and GlaxoSmithKline.
For more information:
Thrall S. #642: Rotavirus Vaccination in Neonatal Intensive Care Units (NICUs): Safety and Feasibility. Presented at: ID Week 2013; Oct. 2-6, San Francisco.