Samuel Thrall1, Margaret K Doll2, Charles Nhan1, Milagros Gonzales1, Thérèse Perreault3, Philippe Lamer3, Caroline Quach4. 1. Infectious Disease Division and Department of Medical Microbiology, The Montreal Children's Hospital, Montreal, QC, Canada. 2. Infectious Disease Division and Department of Medical Microbiology, The Montreal Children's Hospital, Montreal, QC, Canada; Department of Epidemiology & Biostatistics, McGill University, Montreal, QC, Canada. 3. Division of Neonatology and Department of Pediatrics, The Montreal Children's Hospital, Montreal, QC, Canada. 4. Infectious Disease Division and Department of Medical Microbiology, The Montreal Children's Hospital, Montreal, QC, Canada; Department of Epidemiology & Biostatistics, McGill University, Montreal, QC, Canada. Electronic address: caroline.quach@mcgill.ca.
Abstract
BACKGROUND & OBJECTIVES: Preterm infants are at highest risk for severe rotavirus gastroenteritis. While rotavirus vaccination is recommended for age-eligible, clinically stable preterm infants, controversy exists regarding vaccination of these infants during hospitalization. The objectives of this study were to examine tolerance of pentavalent rotavirus vaccination (RV5) among hospitalized infants and nosocomial rotavirus transmission in the neonatal intensive care units (NICU) at two urban hospitals. METHODS: A retrospective, medical chart review of patients receiving RV5 vaccine was conducted to examine clinical histories of vaccine recipients. Average risk differences of gastrointestinal complications were estimated between the three days prior and up to four weeks following RV5 vaccination. A generalized linear regression model was used to examine the association between days since RV5 administration and daily feeding totals, using fixed effects to account for individual-level clustering. Rates of nosocomial rotavirus from active surveillance were compared between pre- and post-NICU-based vaccination periods. RESULTS: From July 1, 2011 to March 30, 2013, RV5 vaccination was initiated for 102 NICU patients. No changes in the average risk of gastrointestinal complications or daily feeding among participants overall were detected following RV5 administration. Rates of nosocomial rotavirus were similar during the periods before and after NICU-based vaccination. CONCLUSIONS: On average, RV5 appeared to be well tolerated among vaccine recipients, with no increase in nosocomial rotavirus transmission observed following NICU-based rotavirus vaccination. While the benefits of a RV5 NICU-based vaccination program for otherwise eligible preterm infants seem to outweigh the possible risk of vaccine virus transmission, further studies are needed.
BACKGROUND & OBJECTIVES: Preterm infants are at highest risk for severe rotavirus gastroenteritis. While rotavirus vaccination is recommended for age-eligible, clinically stable preterm infants, controversy exists regarding vaccination of these infants during hospitalization. The objectives of this study were to examine tolerance of pentavalent rotavirus vaccination (RV5) among hospitalized infants and nosocomial rotavirus transmission in the neonatal intensive care units (NICU) at two urban hospitals. METHODS: A retrospective, medical chart review of patients receiving RV5 vaccine was conducted to examine clinical histories of vaccine recipients. Average risk differences of gastrointestinal complications were estimated between the three days prior and up to four weeks following RV5 vaccination. A generalized linear regression model was used to examine the association between days since RV5 administration and daily feeding totals, using fixed effects to account for individual-level clustering. Rates of nosocomial rotavirus from active surveillance were compared between pre- and post-NICU-based vaccination periods. RESULTS: From July 1, 2011 to March 30, 2013, RV5 vaccination was initiated for 102 NICU patients. No changes in the average risk of gastrointestinal complications or daily feeding among participants overall were detected following RV5 administration. Rates of nosocomial rotavirus were similar during the periods before and after NICU-based vaccination. CONCLUSIONS: On average, RV5 appeared to be well tolerated among vaccine recipients, with no increase in nosocomial rotavirus transmission observed following NICU-based rotavirus vaccination. While the benefits of a RV5 NICU-based vaccination program for otherwise eligible preterm infants seem to outweigh the possible risk of vaccine virus transmission, further studies are needed.
Authors: Rachel M Burke; Jacqueline E Tate; George S Han; Rebecca Quenelle; Rashi Gautam; Debra A Wadford; Michael D Bowen; Umesh D Parashar Journal: J Pediatric Infect Dis Soc Date: 2020-07-13 Impact factor: 3.164