Evaluation of Intussusception Following Rotavirus Vaccination in Africa

Details

• Alternative Title:
  N Engl J Med
• Personal Author:
  Tate, Jacqueline E. ; Mwenda, Jason M. ; Armah, George ; Jani, Bhavin ; Omore, Richard ; Ademe, Ayesheshem ; Mujuru, Hilda ; Mpabalwani, Evans ; Ngwira, Bagrey ; Cortese, Margaret M. ; Mihigo, Richard ; Glover-Addy, Hope ; Mbaga, Mwajabu ; Osawa, Francis ; Tadesse, Amezene ; Mbuwayesango, Bothwell ; Simwaka, Julia ; Cunliffe, Nigel ; Lopman, Benjamin A. ; Weldegebriel, Goitom ; Ansong, Daniel ; Msuya, David ; Ogwel, Billy ; Karengera, Thomas ; Manangazira, Portia ; Bvulani, Bruce ; Yen, Catherine ; Zawaira, Felicitas R. ; Narh, Clement T. ; Mboma, Lazaro ; Saula, Peter ; Teshager, Fasil ; Getachew, Halle ; Moeti, Rebecca Matshidiso ; Eweronu-Laryea, Christabel ; Parashar, Umesh D.
• Corporate Authors:
  African Intussusception Surveillance Network
• Description:
  Background:
  
  Post-licensure evaluations have identified an association between rotavirus vaccination and intussusception in several high and middle-income countries. We assessed the association between monovalent human rotavirus vaccine and intussusception in seven lower income African countries.
  
  Methods:
  
  Intussusception cases meeting international (Brighton level 1) criteria were enrolled using active surveillance. Rotavirus vaccination status was confirmed by review of the vaccine card or clinic records. The risk of intussusception within 1–7 and 8–21 days of vaccination among children 28–245 days of age was assessed using the self-controlled case-series method.
  
  Results:
  
  Data from 717 children with intussusception and confirmed vaccination status were analyzed. One case was observed in the 1–7 days and 6 cases in the 8–21 days post dose 1. Five cases and 16 cases were observed in the 1–7 days and 8–21 days post dose 2. No elevated risk of intussusception was detected in the 1–7 days post dose 1 (relative incidence (RI): 0.25; 95% confidence interval (CI), <0.001–1.03) or in the 1–7 days post-dose 2 (1–7 days: RI: 0.76; 95% CI, 0.17–1.70). Similarly, no elevated risk was detected in the 8–21 or 1–21 days post dose 1 or post dose 2.
  
  Conclusions:
  
  An increased risk of intussusception following monovalent human rotavirus vaccine administration was not identified in these seven, lower income, sub-Saharan African countries.
  
  
• Subjects:
  Africa South Of The Sahara Female Humans Immunization Schedule Incidence Infant Intussusception Male Risk Rotavirus Infections Rotavirus Vaccines Time-to-Treatment Vaccines, Attenuated

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• Source:
  N Engl J Med. 378(16):1521-1528
• DOI:
  http://dx.doi.org/10.1056/NEJMoa1713909
• Pubmed ID:
  29669224
• Pubmed Central ID:
  PMC11748062
• Document Type:
  Journal Article
• Funding:
  001/WHO_/World Health OrganizationInternational/ ; CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  378
• Issue:
  16
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:3a4e64eae1b9f9d372a13b875aa1ceeb7bb22f06853b80515dafb88d862ced4662a9862d592f87cdfed443acabd8494cf8e46d6ae3ec27ff675b63095e325dca
• Download URL:
  https://stacks.cdc.gov/view/cdc/175934/cdc_175934_DS1.pdf
• File Type:
  [PDF - 467.09 KB ]