Health & Medical Children & Kid Health

Intussusception and Rotavirus Vaccines

´╗┐Intussusception and Rotavirus Vaccines

A Class Effect?

All rotavirus vaccines that have been licensed to date have demonstrated a temporally increased intussusception risk of varying degree. This includes 2 different reassortant vaccines as well as an attenuated human monovalent strain. This suggests all rotavirus vaccines may carry some risk, and clinical trials may be insufficiently powered to detect a small risk. This is especially relevant for new rotavirus candidates, including the Indian 116E human monovalent strain, the UK bovine-human reassortant vaccine and the Australian human monovalent candidate RV3, with the first dose intended at birth, when intussusception risk is lowest. Post-licensure risk management plans that incorporate surveillance strategies to detect and quantify intussusception risk will be important, both for new rotavirus vaccines, and countries introducing rotavirus vaccines. The presence of a class effect, if proven, should restimulate investigations into whether, despite the weight of negative evidence to date, low level wild type rotavirus infection may indeed be associated with intussusception.

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