Severity of Rotavirus-Vaccine-Associated Intussusception: Prospective Hospital-Based Surveillance, Australia, 2007-2018

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dc.contributor.authorSheel, M.
dc.contributor.authorWood, N.
dc.contributor.authorMacartney, K.
dc.contributor.authorButtery, J.
dc.contributor.authorDinsmore, N.
dc.contributor.authorMarshall, H.
dc.contributor.authorElliott, E.
dc.contributor.authorKynaston, A.
dc.contributor.authorRichmond, P.
dc.contributor.authorChateau, D.
dc.contributor.authorMcIntyre, P.
dc.date.issued2022
dc.description.abstractBackground: Multiple studies have shown an association between intus susception (IS) and receipt of monovalent or pentavalent rotavirus vaccine (RV) in the previous 21 days. Disease severity is an important consideration for risk-benefit evaluations of RV, but no studies have compared the severity of IS within 21 days of vaccination (vaccine-associated, VA) and later (not temporally-associated, VNA). Methods: We used active hospital-based surveillance in the Australian Pae diatric Active Enhanced Disease Surveillance (PAEDS) network (July 2007 to February 2018) to identify infants ≤9 months of age meeting Brighton level 1 criteria for IS. We used five severity levels: (1) no surgery and length of stay (LOS) ≤1 day, (2) no surgery and LOS ≥2 days, (3) surgery, no bowel resection, (4) bowel resection, and (5) ICU admission. Results: Of 323 eligible cases, 87 (26.9%) were VA and 236 (73.1%) VNA. VA-IS cases (median 21 weeks; 24.1% ≤14 weeks) were significantly younger than VNA-IS cases (median 28 weeks, 7.2% ≤14 weeks). Cases 0–≤14 weeks of age were significantly more likely than cases ≥25 weeks to require bowel resection (relative risk ratio 4.6, 95% CI, 1.48–14.3). This effect was not associated with RV. After adjustment for age and sex, VA-IS was not significantly overrepresented in severity levels 2–5; adjusted RRR of 1.37 (95% CI: 0.61–3.11) for bowel resection in cases 0–≤14 weeks of age. Conclusions: IS was uncommon but significantly more severe under 14 weeks of age. After adjustment for age and sex, IS severity was not related to RV.
dc.description.statementofresponsibilityMeru Sheel, PhD, Nicholas Wood, PhD, Kristine Macartney, MD, Jim Buttery, PhD, Nicole Dinsmore, BN, Helen Marshall, MD, Elizabeth Elliott, MD, Anne Kynaston, FRACP, Peter Richmond, FRACP, Dan Chateau, PhD, and Peter McIntyre, PhD, on behalf of PAEDS Network.
dc.identifier.citationThe Pediatric Infectious Disease Journal, 2022; 41(6):507-513
dc.identifier.doi10.1097/INF.0000000000003521
dc.identifier.issn0891-3668
dc.identifier.issn1532-0987
dc.identifier.orcidMarshall, H. [0000-0003-2521-5166]
dc.identifier.urihttps://hdl.handle.net/2440/135504
dc.language.isoen
dc.publisherLippincott, Williams & Wilkins
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/GNT1113851
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/GNT1063629
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1155066
dc.rightsCopyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
dc.source.urihttps://doi.org/10.1097/inf.0000000000003521
dc.subjectrotavirus vaccine
dc.subjectintussusception
dc.subjectpostmarketing surveillance
dc.subjectRV5
dc.subjectRV1
dc.subjectimmunization
dc.subjectseverity
dc.subjectmorbidity
dc.subject.meshHumans
dc.subject.meshRotavirus
dc.subject.meshRotavirus Infections
dc.subject.meshIntussusception
dc.subject.meshVaccines, Combined
dc.subject.meshRotavirus Vaccines
dc.subject.meshVaccination
dc.subject.meshProspective Studies
dc.subject.meshChild
dc.subject.meshInfant
dc.subject.meshHospitals
dc.subject.meshAustralia
dc.titleSeverity of Rotavirus-Vaccine-Associated Intussusception: Prospective Hospital-Based Surveillance, Australia, 2007-2018
dc.typeJournal article
pubs.publication-statusPublished

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