Immunization Safety Office, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention USA.
Viral Gastroenteritis Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention USA.
Vaccine. 2021 Jan 22;39(4):746-750. doi: 10.1016/j.vaccine.2020.11.026. Epub 2020 Nov 29.
In 2006 and 2008, two live, oral rotavirus vaccines, RotaTeq (RV5) and Rotarix (RV1), were introduced into the routine immunization program in the United States. A previous rotavirus vaccine, RotaShield, was associated with an increased risk of intussusception, with data suggesting an age-dependent variation in risk. Advisory Committee on Immunization Practices (ACIP) currently recommends that RV5 or RV1 immunization be initiated by age 14 weeks and 6 days and completed by 8 months 0 days.
We searched for U.S. VAERS reports of RV5, RV1, or unknown rotavirus vaccine brand among individuals aged ≥8 months. We analyzed reports by 2 age groups (individuals aged ≥8 months-≤5 years and ≥6 years), vaccine brand name, adverse event (AE) reported, classification of seriousness (death, non-death serious, and non-serious) and mode of exposure (direct vs. indirect exposure). For serious reports we reviewed available medical records and assigned a primary diagnosis.
VAERS received a total of 344 U.S. reports following rotavirus vaccination among individuals ≥8 months of age, 32 (9.3%) were serious. In the younger age-group, 307 (99%) of 309 reports followed direct vaccination of the child. In contrast, in individuals aged ≥6 years, 21 (60%) of 35 reports were via potential indirect exposure to a vaccinated child. The frequently reported AEs in the younger age-group were inappropriate schedule of drug administration 104 (34%) and drug administered to patient of inappropriate age 45 (15%); in the older group these were accidental exposure 9 (26%) and eye irritation 7 (20%). No difference in the safety profile was observed between RV1 and RV5.
We did not identify any unexpected AEs for RV vaccines among individuals aged ≥8 months. Health care providers should adhere to the ACIP recommended schedule and older individuals should apply necessary precautions to prevent potential secondary exposure from vaccinated children.
2006 年和 2008 年,两种活的口服轮状病毒疫苗,RotaTeq(RV5)和 Rotarix(RV1),被引入美国常规免疫计划。以前的轮状病毒疫苗,RotaShield,与肠套叠的风险增加有关,数据表明风险存在年龄依赖性变化。免疫实践咨询委员会(ACIP)目前建议 RV5 或 RV1 免疫接种应在 14 周零 6 天龄和 8 个月零 0 天龄内完成。
我们在美国 VAERS 报告中搜索了 8 个月以上人群中 RV5、RV1 或未知轮状病毒疫苗品牌的报告。我们按 2 个年龄组(8 个月至 5 岁以下和 6 岁以上)、疫苗品牌名称、报告的不良事件(AE)、严重程度分类(死亡、非死亡严重和非严重)和暴露模式(直接和间接暴露)进行分析。对于严重报告,我们审查了可用的医疗记录并分配了主要诊断。
VAERS 总共收到了 344 份 8 个月以上人群接种轮状病毒疫苗后的美国报告,其中 32 份(9.3%)为严重报告。在年龄较小的年龄组中,309 份报告中的 307 份(99%)直接接种了儿童。相比之下,在 6 岁以上的人群中,35 份报告中的 21 份(60%)是通过接种儿童的潜在间接接触。年龄较小的年龄组中报告频率较高的 AE 是药物给药不当 104 例(34%)和给不合适年龄的患者给药 45 例(15%);在年龄较大的组中,这些是意外暴露 9 例(26%)和眼部刺激 7 例(20%)。在 RV1 和 RV5 之间未观察到安全性特征的差异。
我们在 8 个月以上的人群中没有发现 RV 疫苗的任何意外 AE。医疗保健提供者应遵守 ACIP 推荐的时间表,年龄较大的个体应采取必要的预防措施,以防止接种儿童的潜在二次暴露。