BOSTON The estimated benefitrisk ratio for
rotavirus vaccination and hospitalizations due to vaccination-associated
intussusception was more than 800 to 1, according to findings presented at the
IDSA 49th Annual Meeting.
Rishi Desai, MD, MPH, an epidemic intelligence
service officer in the division of viral diseases at the CDC, presented data
from the 14 Latin American countries currently employing rotavirus
immunization. The benefits of rotavirus vaccine far outweigh the
intussusceptions risk, and continued vaccination will save thousands of lives
and hospitalizations every year in Latin America, he told Infectious
Diseases in Children. Physicians have to be aware of the benefits and
risks of vaccination so that they can offer these life-saving interventions to
Health officials have recently been obliged to weigh the
risks and benefits of rotavirus immunization in light of recent postlicensure
identification of an increased risk for intussusception associated with it. The
current trial compared two estimates in the 14 countries: the excess
intussusception risk associated with the vaccine and the number of
hospitalizations and deaths expected to be averted through vaccination.
Postlicensure findings from Mexico and Brazil were used
to create intussusception RR ratio estimates. Compared with baseline, the RR
for intussusception in those cohorts 1 week after the first dose was 5.3 (95%
CI, 3-9.3). A week after the second dose, the RR was 2.6 (95% CI, 1.3-5.2).
Assuming an aggregate birth cohort of 9.5 million
infants from the 14 countries studied, for each year of the first 5 years of
life, the rotavirus vaccine would be expected to prevent 137,498
hospitalizations and 2,523 deaths due to rotavirus. However, there would be 162
additional hospitalizations and 10 additional deaths due to intussusception.
The resulting benefit-to-risk ratio is 846 to 1 for hospitalizations and 255 to
1 for death.
Reassuringly, the level of intussusception risk
with the new vaccines (Rotarix, GlaxoSmithKline; and RotaTeq, Merck) is far
lower than that with the previous vaccine, Rotashield (Wyeth), Desai
The disease burden and vaccine efficacy data were
combined with global natural intussusception and country-specific diptheria,
tetanus toxoids and pertussis vaccination coverage rates to estimate the extent
of rotavirus vaccine coverage.
Disclosure: Dr. Desai reports no relevant
For more information:
- Desai R. #330. Presented at: IDSA 49th Annual Meeting;
Oct. 20-23, 2011; Boston.