New Delhi, Dec 9 Administering rotavirus vaccine to babies during their stay in a neonatal intensive care unit (NICU) could be safe, finds a study on Monday, that could serve as the basis for a change in clinical practice.
The study by researchers from the Children’s Hospital of Philadelphia (CHOP) showed that transmission of rotavirus vaccine strains in a NICU is rare.
But administering the rotavirus vaccine will provide immune benefits that outweigh any risks, said the team. The findings could serve as the basis for a change in clinical practice.
Rotavirus is a virus that infects the lining of the intestines and is typically characterised by symptoms such as high fever, persistent and severe vomiting, and diarrhoea. It remains the most common cause of diarrhea in infants and young children. It has contributed to roughly half a million child deaths worldwide.
Usually, the first dose of a rotavirus vaccine is given to newborns at two months old.
Historically, many NICUs do not give rotavirus vaccines to inpatients due to a theoretical risk of horizontal transmission of vaccine strains, meaning that the strains of the virus in the vaccine could potentially infect at-risk patients since some vaccinated infants shed live, attenuated vaccine-strain rotavirus in their stool for weeks after administration.
Holding vaccination until patients are discharged from the NICU often leaves infants with long hospitalisations, who are most vulnerable to severe rotavirus disease due to underlying health conditions, potentially making them ineligible to ever receive the vaccine. Prior retrospective studies found a very minimal risk of horizontal transmission in NICU settings.
The study, published today in the journal Pediatrics, examined 1,238 infants admitted, with 226 doses of the RotaTeq vaccine administered.
A total of 3,448 stool samples were analysed, including 2,252 from 686 unvaccinated patients. The vast majority of those unvaccinated patients (681, or 99.3 per cent) never tested positive for the rotavirus vaccine strain.
The remaining five patients tested positive for a rotavirus vaccine strain. No gastroenteritis symptoms were identified in those transmission cases.
“Ultimately, these findings add to the existing safety data and suggest the known benefits of NICU administration of the rotavirus vaccine outweigh the low risks of vaccine-strain transmission,” said Kathleen A. Gibbs, neonatologist in the Division of Neonatology at CHOP.
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