A new study from researchers at the Children’s Hospital of Philadelphia (CHOP) has shed light on the transmission of rotavirus vaccine strains in neonatal intensive care units (NICUs).
The intriguing conclusion: such transmission is rare and doesn’t cause clinical issues.
These findings, published in the journal Pediatrics, suggest that vaccinating eligible infants while they’re hospitalized might offer substantial immune benefits, outweighing any potential risks associated with the vaccine.
This could lead healthcare professionals to rethink current vaccination practices in NICUs.
Understanding Rotavirus and Its Impact
Rotavirus is notorious for attacking the intestinal lining, triggering severe health issues like high fevers, relentless vomiting, and serious diarrhea.
Before the advent of rotavirus vaccines, nearly every child would contract the virus before turning five, resulting in approximately 500,000 childhood deaths worldwide each year, along with tens of thousands of hospitalizations in the United States alone.
Despite effective vaccines being available now, rotavirus remains the leading cause of diarrhea in young children.
Study Findings and Methodology
The vaccine is usually first administered when infants are around two months old.
However, many NICUs have historically hesitated to vaccinate inpatients, largely due to fears of horizontal transmission.
This concern arises from the understanding that vaccinated infants may shed live, weakened virus in their stools for weeks after receiving the vaccine, potentially infecting unvaccinated, vulnerable patients.
Postponing vaccination until discharge can jeopardize those infants who may have extended hospital stays due to health complications, inhibiting their access to vaccination altogether.
Earlier studies have indicated a very minimal risk of this type of transmission in NICUs.
Dr. Susan E. Coffin, a co-senior author of the latest research, emphasized that their study found vaccine virus transmission to be quite uncommon and, importantly, without any clinical symptoms arising from those rare instances.
Conducted in a well-equipped NICU with both shared and private rooms, the research further illustrates that the likelihood of transmitting vaccine-strain rotavirus among unvaccinated infants in these critical care settings is statistically low.
Collaboration among various divisions at CHOP, including Infectious Diseases and Neonatology, helped fuel the study’s success.
Over the course of a year, every patient admitted to the hospital’s 100-bed N/IICU was included in the study group.
Researchers collected and tested weekly stool samples for the presence of vaccine-strain rotavirus whenever transmission was suspected.
Of the 1,238 infants involved in the study, researchers administered 226 doses of the RotaTeq vaccine.
They meticulously examined a total of 3,448 stool samples, including 2,252 from 686 unvaccinated infants.
Remarkably, 99.3% of those unvaccinated—681 infants—showed no signs of vaccine-strain rotavirus.
Only five infants tested positive, and none exhibited symptoms of gastroenteritis.
Implications for Future Vaccination Practices
Dr. Kathleen A. Gibbs noted the significance of this study for NICUs of diverse sizes and configurations.
She emphasized that the data supports existing safety evidence and suggests that the advantages of vaccinating infants in NICUs far outweigh the minimal risks of potential vaccine-strain transmission.
This pivotal research received financial backing through a grant from the Centers for Disease Control and Prevention (CDC), marking an important step forward in the fight against rotavirus in vulnerable populations.
Source: ScienceDaily