Wang Guoyong, Zhang Kaijun, Zhang Rensen, Kong Xiangru, Guo Chunbao
Department of Pediatrics, Women and Children's Hospital of Chongqing Medical University, Chongqing, China.
Department of Pediatric General Surgery, Children's Hospital, Chongqing Medical University, Chongqing, China.
Front Pediatr. 2023 Jul 31;11:1239423. doi: 10.3389/fped.2023.1239423. eCollection 2023.
Intussusception is a prevalent pediatric issue causing acute abdominal pain, with potential links to rotavirus vaccines. The variety of these vaccines has grown in recent years. This meta-analysis study aims to evaluate the impact of various rotavirus vaccines on intussusception incidence.
We executed a thorough search across databases like PubMed, Cochrane Library, Embase, and Web of Science, leading to the selection of 15 credible randomized controlled trials (RCTs) that encompass various types of rotavirus vaccines. From each study, we extracted essential details such as vaccine types and intussusception occurrences. We assessed the risk of bias using the Cochrane Collaboration's tool, conducted statistical analysis with R (version 4.2.3), determined relative risk (RR) using a random effects model, and performed a subgroup analysis for vaccines of differing brands and types.
We included 15 randomized controlled studies from various countries. While intussusception incidence differed between vaccinated and control groups, this difference was not statistically significant. The overall risk ratio (RR), calculated using a random effects model, was 0.81, with a 95% confidence interval of [0.53, 1.23]. This crossing 1 shows that vaccination didn't notably change disease risk. Additionally, the 0% group heterogeneity suggests consistency across studies, strengthening our conclusions. Subgroup analysis for different vaccine brands and types (RV1 (Rotarix, Rotavac, RV3-BB), RV3 (LLR3), RV5 (RotasiiL, RotaTeq), and RV6) showed no significant variation in intussusception incidence. Despite variations in RR among subgroups, these differences were not statistically significant ( > 0.05).
Our study indicates that rotavirus vaccination does not significantly increase the incidence of intussusception. Despite varying impacts across different vaccine brands and types, these variations are insignificant. Given the substantial benefits outweighing the risks, promoting the use of newly developed rotavirus vaccines remains highly valuable.
www.crd.york.ac.uk/prospero/, Identifier CRD42023425279.
肠套叠是引起小儿急性腹痛的常见问题，可能与轮状病毒疫苗有关。近年来，此类疫苗种类不断增加。本荟萃分析旨在评估各种轮状病毒疫苗对肠套叠发病率的影响。
我们全面检索了PubMed、Cochrane图书馆、Embase和Web of Science等数据库，筛选出15项可靠的随机对照试验（RCT），这些试验涵盖了各种类型的轮状病毒疫苗。我们从每项研究中提取了疫苗类型和肠套叠发生情况等关键信息。我们使用Cochrane协作工具评估偏倚风险，用R（版本4.2.3）进行统计分析，采用随机效应模型确定相对风险（RR），并对不同品牌和类型的疫苗进行亚组分析。
我们纳入了来自不同国家的15项随机对照研究。虽然接种疫苗组和对照组的肠套叠发病率有所不同，但这种差异无统计学意义。采用随机效应模型计算的总体风险比（RR）为0.81，95%置信区间为[0.53, 1.23]。这个区间跨越1表明接种疫苗并没有显著改变疾病风险。此外，0%的组间异质性表明各研究结果具有一致性，强化了我们的结论。对不同疫苗品牌和类型（RV1（Rotarix、Rotavac、RV3-BB）、RV3（LLR3）、RV5（RotasiiL、RotaTeq）和RV6）的亚组分析显示，肠套叠发病率无显著差异。尽管亚组间RR存在差异，但这些差异无统计学意义（>0.05）。
我们的研究表明，接种轮状病毒疫苗不会显著增加肠套叠的发病率。尽管不同疫苗品牌和类型的影响有所不同，但这些差异并不显著。鉴于益处远大于风险，推广使用新开发的轮状病毒疫苗仍然非常有价值。
