Evaluation of Intussusception Following Pentavalent Rotavirus Vaccine (RotaTeq) Administration in 5 African Countries

Author:

Tate Jacqueline E1,Mwenda Jason M2,Keita Adama Mamby3,Tapsoba Toussaint Wendlamita4,Ngendahayo Edouard5,Kouamé Bertin Dibi6,Samateh Ahmadou Lamin7,Aliabadi Negar1,Sissoko Seydou3,Traore Yacouba8,Bayisenga Justin9,Sounkere-Soro Moufidath6,Jagne Sheriffo10,Burke Rachel M1,Onwuchekwa Uma3,Ouattara Ma11,Bikoroti Joel B12,N’Zue Kofi13,Leshem Eyal1,Coulibaly Oumar14,Ouedraogo Issa15,Uwimana Jeannine12,Sow Samba3,Parashar Umesh D1,Zampou Olivier,Bah Abdoulie,Sey Alhagie Papa,Sonko Mariama,Bizumuremyi Yves C M,Mukanyange Violette,Niwenkunda Jeannette,Nkurunziza Charles Twagirayezu,

Affiliation:

1. US Centers for Disease Control and Prevention , Atlanta, Georgia , USA

2. World Health Organization Regional Office for Africa , Brazzaville , Congo

3. Center for Vaccine Development , Bamako , Mali

4. Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle , Ouagadougou , Burkina Faso

5. King Faisal Hospital , Kigali , Rwanda

6. University Hospital of Yopougon , Abidjan , Cote d’Ivoire

7. Ministry of Health , Banjul , The Gambia

8. Centre Hospitalier Universitaire Sourou SANOU de Bobo Dioulasso , Bobo Dioulasso , Burkina Faso

9. University Teaching Hospital of Butare , Butare , Rwanda

10. National Public Health Reference Laboratory, Ministry of Health , Banjul , The Gambia

11. World Health Organization Country Office , Ouagadougou , Burkina Faso

12. University Teaching Hospital of Kigali , Kigali , Rwanda

13. World Health Organization Country Office , Abidjan , Cote d’Ivoire

14. Centre Hospitalier Universitaire Gabriel Touré , Bamako , Mali

15. Ministry of Health, Expanded Program on Immunizations , Ouagadougou , Burkina Faso

Abstract

Abstract Background A low-level risk of intussusception following rotavirus vaccination has been observed in some settings and may vary by vaccine type. We examined the association between RotaTeq vaccination and intussusception in low-income settings in a pooled analysis from 5 African countries that introduced RotaTeq into their national immunization program. Methods Active surveillance was conducted at 20 hospitals to identify intussusception cases. A standard case report form was completed for each enrolled child, and vaccination status was determined by review of the child's vaccination card. The pseudo-likelihood adaptation of self-controlled case-series method was used to assess the association between RotaTeq administration and intussusception in the 1–7, 8–21, and 1–21 day periods after each vaccine dose in infants aged 28–245 days. Results Data from 318 infants with confirmed rotavirus vaccination status were analyzed. No clustering of cases occurred in any of the risk windows after any of the vaccine doses. Compared with the background risk of naturally occurring intussusception, no increased risk was observed after dose 1 in the 1–7 day (relative incidence = 2.71; 95% confidence interval [CI] = 0.47–8.03) or the 8–21 day window (relative incidence = 0.77; 95%CI = 0.0–2.69). Similarly, no increased risk of intussusception was observed in any risk window after dose 2 or 3. Conclusions RotaTeq vaccination was not associated with increased risk of intussusception in this analysis from 5 African countries. This finding mirrors results from similar analyses with other rotavirus vaccines in low-income settings and highlights the need for vaccine-specific and setting-specific risk monitoring.

Funder

CDC Foundation

WHO

Edward Francis Small Teaching Hospital

CDC Atlanta

Ministry of Health of Burkina Faso

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Microbiology (medical)

Reference31 articles.

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2. Intussusception among recipients of rotavirus vaccine;Centers for Disease Control and Prevention;MMWR Morb Mortal Wkly Rep,1999

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