Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN 55902, United States.
Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN 55902, United States.
Vaccine. 2023 Jul 12;41(31):4453-4456. doi: 10.1016/j.vaccine.2023.06.040. Epub 2023 Jun 17.
The patient is an otherwise healthy two-month-old boy who received the recommended vaccinations for his age group, which included the rotavirus pentavalent vaccine (RV5; RotaTeq) at his two-month well child visit. Three days later, he developed prolonged non-bloody diarrhea and was found to have persistently positive rotavirus antigen in his stool. Subsequent workup revealed mild defects in his functional T-cell immunocompetence. Genetic testing was obtained through the Invitae panel and was negative for hereditary forms of primary immunodeficiencies. The rotavirus antigen was found to have cleared from his stool around four months after receiving the RV5. Unfortunately, the source of the rotavirus infection was unable to be determined. The caregivers had misconceptions about the vaccine and the child's immune system function which led to refusal of any further vaccinations. Healthcare providers should strive to develop honest and respectful relationships with parents to have thoughtful dialogues regarding vaccine safety and efficacy.
患儿为 otherwise healthy 两个月大男婴，在两个月大健康检查时，按年龄组接受了建议的疫苗接种，包括轮状病毒五价疫苗（RV5；RotaTeq）。三天后，他出现迁延不愈的非血性腹泻，粪便持续检测到轮状病毒抗原阳性。进一步检查发现其功能性 T 细胞免疫功能有轻微缺陷。通过 Invitae 面板进行了基因检测，未发现原发性免疫缺陷的遗传性形式。RV5 接种后约四个月，患儿粪便中的轮状病毒抗原清除。不幸的是，未能确定轮状病毒感染的来源。患儿看护者对疫苗和患儿的免疫系统功能存在误解，导致拒绝接受任何进一步的疫苗接种。医疗保健提供者应努力与父母建立诚实和相互尊重的关系，就疫苗安全性和有效性进行深思熟虑的对话。
