Department of Pediatrics, Akita University Graduate School of Medicine, Akita, Japan.
Jpn J Infect Dis. 2012 Jul;65(4):301-5.
One concern about rotavirus vaccines is its possible association with intussusception. Thus, it is necessary to determine the baseline incidence for intussusception in the first year of life in places where rotavirus vaccines are introduced. However, few safety data exist for the period at which the first dose of Rotarix and RotaTeq are allowed to administer in Japan. The first dose of Rotarix is scheduled to administer at 6-20 weeks of age and that of RotaTeq is scheduled to administer at 6-24 weeks of age; the upper limits for these vaccines is later than the upper limit recommended by the World Health Organization by 5 and 9 weeks, respectively. We performed a retrospective cross-sectional study by reviewing medical charts of all hospitals that provided pediatric beds in Akita Prefecture, Japan, and identifying the cases of intussusception that met the Brighton criteria level 1 in these hospitals between January 2001 and December 2010. During this 10-year period, 122 children younger than 1 year of age were diagnosed with intussusception. The incidence of intussusception was estimated at 158 per 100,000 person-years among children younger than 1 year (95% confidence interval, 131-188), 10 per 100,000 person-years for children aged 0-2 months, 165 for children aged 3-5 months, and 300 for children aged 6-8 months. This rapid and substantial increase in the incidence of intussusception during the first year of life should be considered when formulating the immunization schedule for administering rotavirus vaccines in Japan.
轮状病毒疫苗的一个担忧是其可能与肠套叠有关。因此，有必要确定轮状病毒疫苗引入地区在生命的第一年肠套叠的基础发病率。然而，在日本，Rotarix 和 RotaTeq 可以接种第一针的时期，安全数据很少。Rotarix 的第一针计划在 6-20 周龄时接种，RotaTeq 的第一针计划在 6-24 周龄时接种；这两种疫苗的上限比世界卫生组织推荐的上限分别晚了 5 周和 9 周。我们通过回顾日本秋田县所有提供儿科病床的医院的病历，对所有医院进行了回顾性横断面研究，并确定了这些医院在 2001 年 1 月至 2010 年 12 月期间符合布莱顿标准 1 级的肠套叠病例。在这 10 年期间，有 122 名年龄小于 1 岁的儿童被诊断为肠套叠。年龄小于 1 岁的儿童肠套叠发病率估计为每 100,000 人年 158 例（95%置信区间，131-188），0-2 个月儿童每 100,000 人年 10 例，3-5 个月儿童每 100,000 人年 165 例，6-8 个月儿童每 100,000 人年 300 例。在制定日本轮状病毒疫苗接种时间表时，应考虑到生命第一年肠套叠发病率的这种快速和显著增加。
