Rotavirus vaccination and intussusception - Science, surveillance, and safety: A review of evidence and recommendations for future research priorities in low and middle income countries.
As of January 2016, 80 countries have introduced rotavirus vaccines into their national immunization programs. Many have documented significant declines in rotavirus-specific and all-cause diarrheal illnesses following vaccine introduction. Two globally licensed rotavirus vaccines have been associated with a low risk of intussusception in several studies. In July 2014, the Rotavirus Organization of Technical Allies Council convened a meeting of research and advocacy organizations, public health experts, funders, and vaccine manufacturers to discuss post-marketing intussusception surveillance and rotavirus vaccine impact data. Meeting objectives were to evaluate updated data, identify and prioritize research gaps, discuss best practices for intussusception monitoring in lower-income settings and risk communication, and provide insight to country-level stakeholders on best practices for intussusception monitoring and communication. Meeting participants agreed with statements from expert bodies that the benefits of vaccination with currently available rotavirus vaccines outweigh the low risk of vaccination-associated intussusception. However, further research is needed to better understand the relationship of intussusception to wild-type rotavirus and rotavirus vaccines and delineate potential etiologies and mechanisms of intussusception. Additionally, evidence from research and post-licensure evaluations should be presented with evidence of the benefits of vaccination to best inform policymakers deciding on vaccine introduction or vaccination program sustainability.
a Division of Viral Diseases, Centers for Disease Control and Prevention , Atlanta , GA , USA.
Catherine
C
Yen
b Johns Hopkins University Bloomberg School of Public Health , Baltimore , MD , USA.
Kelly
K
Healy
a Division of Viral Diseases, Centers for Disease Control and Prevention , Atlanta , GA , USA.
Jacqueline E
JE
Tate
a Division of Viral Diseases, Centers for Disease Control and Prevention , Atlanta , GA , USA.
Umesh D
UD
Parashar
c Murdoch Childrens Research Institute, The University of Melbourne , Victoria , Australia.
Julie
J
Bines
d University of Maryland School of Medicine , Baltimore , MD , USA.
Kathleen
K
Neuzil
b Johns Hopkins University Bloomberg School of Public Health , Baltimore , MD , USA.
Mathuram
M
Santosham
e Enteric and Diarrhoeal Diseases, Global Health, Bill and Melinda Gates Foundation , Seattle , WA , USA.
A Duncan
AD
Steele
D003906:Developing Countries; D006801:Humans; D007443:Intussusception / Q000139:chemically induced* / Q000453:epidemiology* / Q000503:physiopathology; D011358:Product Surveillance, Postmarketing; D012106:Research; D012400:Rotavirus Infections / Q000517:prevention & control; D022243:Rotavirus Vaccines / Q000008:administration & dosage* / Q000009:adverse effects*
D022243:Rotavirus Vaccines
infants; intussusception; rotavirus; rotavirus vaccine; vaccine