Vaccine for Childhood Diarrhea Helps Kids, Saves
WEDNESDAY, Sept. 21 (HealthDay News) -- Since the 2006
introduction of routine inoculation against rotavirus -- a leading
cause of diarrhea in infants and young children -- almost 65,000
fewer American children have been hospitalized and about $278
million in healthcare costs have been saved, according to new
The vaccine targets rotavirus, a common and easily transmitted
pathogen. The new study, from a team at the U.S. Centers for
Disease Control and Prevention (CDC), found that there were 89
percent fewer rotavirus-specific hospitalizations in children who
had gotten the vaccine compared to unvaccinated children.
"Diarrhea causes by rotavirus is one of the most common illnesses in children. It's usually self-limited and treated at home, but before the vaccine was introduced, the virus was responsible for about 200,000 emergency room visits and 400,000 physician office visits a year," noted the study's senior author, Dr. Umesh Parashar, a medical epidemiologist and team leader of the viral gastroenteritis team at the CDC in Atlanta.
Before routine rotavirus inoculations in 2006, the virus was
associated with 20 to 60 deaths a year in children under 5 in the
United States -- although that figure was much higher in developing
countries. "In the U.S., with good access to healthcare, we can
prevent the worse outcomes from diarrheal illness. Globally, there
are about a half a million deaths caused by this pathogen,"
Results of the study are published in the Sept. 22 issue of the
New England Journal of Medicine.
In 1998, the first rotavirus vaccine became available. However,
it was quickly withdrawn from the market when otherwise healthy
babies began to develop a condition known as intussusception. This
condition causes the bowel to fold into itself, much like a
telescope, triggering an often life-threatening bowel obstruction.
The vaccine was withdrawn from the market in 1999, when the CDC
linked these cases with the administration of the vaccine. The CDC
estimated that for every 10,000 doses of vaccine, about one to two
cases of intussusceptions occurred.
However, rotavirus itself is a risk factor for developing
intussusception, according to information from the CDC, and to
infectious disease specialist, Dr. Marian Michaels, from Children's
Hospital of Pittsburgh, Penn.
Michaels said that before the current, safer versions of the
rotavirus vaccine came to market, studies including tens of
thousands of children were done. "This was really something people
took very seriously. They wanted to make sure that we first cause
no harm," she said.
So, since 2006, two new versions of rotavirus vaccine have been
introduced. The vaccine is given orally at two, four and six months
of age, according to background information in the study. Parashar
said the current study didn't look at rates of intussusception, but
research in Latin America and Australia has found that the
incidence there was approximately one or two per 100,000 babies
The study estimated that if this finding applied to the United
States and all infants in the country were vaccinated, there would
be an additional 50 cases of intussusception and additional health
care costs of about $500,000, in contrast to the tens of thousands
of hospitalizations prevented and millions of dollars saved by
vaccinating against rotavirus.
"The most important thing is that this vaccine decreases the risk of a child getting rotavirus, and possibly needing hospitalization because of dehydration. The benefits of this vaccine outweigh the risks," said Michaels.
Parashar and his colleagues compared 2007-2009 data from U.S.
insurance databases against similar data from 2001 through 2006, to
assess trends in rotavirus hospitalizations, ER visits and
physician-office visits over time.
By the end of 2008, 73 percent of children had gotten at least
one dose of rotavirus vaccine, 64 percent of children between one
and two years of age had at least the initial dose of the vaccine,
and 8 percent of children between two and four years old had at
least one dose. Parashar said the vaccine needs to be given before
children are eight months old.
The researchers found that hospitalization rates for diarrhea
went down as much as 33 percent after introduction of the vaccine.
For rotavirus-specific hospitalizations, the rate went down as much
as 75 percent, according to the study.
When the researchers compared vaccinated and unvaccinated
children, they found the rate of rotavirus-specific
hospitalizations were 89 percent less for vaccinated children. The
number of ER visits were about 48 percent lower for vaccinated
children, and physician office visits were around 12 percent lower
for children who received the vaccine.
"Rotavirus is the most common cause of severe diarrheal illness. The vaccine can prevent and reduce the disease burden substantially," said Parashar.
"This vaccine decreases the risk of a child getting rotavirus and needing hospitalization. I think this is extraordinarily exciting, and we've already seen the reduction in the ER," said Michaels.
Learn more about the rotavirus vaccine from the
U.S. Centers for Disease Control and
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