Intussusception among recipients of rotavirus vaccine: reports to the vaccine adverse event reporting system.
BACKGROUND
Rotavirus vaccine was licensed on August 31, 1998, and subsequently recommended for routine use among infants. To assess rare adverse events, postlicensure surveillance was conducted.


OBJECTIVE
To describe the cases of intussusception among rotavirus vaccine recipients reported to the Vaccine Adverse Event Reporting System from October 1998 through December 1999.


METHODS
Infants vaccinated with rotavirus vaccine in the United States.


METHODS
Intussusception confirmed by radiology, surgery, or autopsy report with medical record documentation or confirmed by a primary health care provider.


RESULTS
There were 98 confirmed cases of intussusception after vaccination with rotavirus vaccine reported to the Vaccine Adverse Event Reporting System; 60 of these developed intussusception within 1 week after vaccination. Based on calculations using vaccine distribution data and intussusception incidence rates from 2 separate databases, an estimated 7 to 16 cases would have been expected to occur in the week after vaccination by chance alone.


CONCLUSIONS
Using a passive surveillance system for vaccine adverse events, we observed at least a fourfold increase over the expected number of intussusception cases occurring within 1 week of receipt of rotavirus vaccine. Other studies were initiated to further define the relationship between rotavirus vaccine and intussusception. In light of these and other data, the rotavirus vaccine manufacturer voluntarily removed its product from the market, and the recommendation for routine use of rotavirus vaccine among US infants has been withdrawn.
Zanardi
L R
LR
Epidemic Intelligence Service Program, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. lzanardi@cdc.gov
Haber
P
P
Mootrey
G T
GT
Niu
M T
MT
Wharton
M
M
D016907:Adverse Drug Reaction Reporting Systems / Q000706:statistics & numerical data*; D017277:Drug Approval / Q000331:legislation & jurisprudence; D006801:Humans; D007223:Infant; D007443:Intussusception / Q000139:chemically induced / Q000453:epidemiology*; D022243:Rotavirus Vaccines / Q000009:adverse effects*; D014481:United States; D014611:Vaccination / Q000009:adverse effects*
D022243:Rotavirus Vaccines