Impact of rotavirus vaccine on premature infants

Abstract

Infants born preterm are at a higher risk of complications and hospitalization in cases of rotavirus diarrhea than children born at term. We evaluated the impact of a rotavirus vaccination campaign (May 2007 to May 2010) on hospitalizations for rotavirus gastroenteritis in a population of children under 3 years old born prematurely (before 37 weeks of gestation) in the Brest University Hospital birth zone. Active surveillance from 2002 to 2006 and a prospective collection of hospitalizations for rotavirus diarrhea were initiated in the pediatric units of Brest University Hospital until May 2010. Numbers of hospitalizations for rotavirus diarrhea among the population of children born prematurely, before and after the start of the vaccination program, were compared using a Poisson regression model controlling for epidemic-to-epidemic variation. A total of 217 premature infants were vaccinated from 2007 to 2010. Vaccine coverage for a complete course of three doses was 41.9%. The vaccine safety in premature infants was similar to that in term infants. The vaccination program led to a division by a factor of 2.6 (95% confidence interval [CI], 1.3 to 5.2) in the number of hospitalizations for rotavirus diarrhea during the first two epidemic seasons following vaccine introduction and by a factor of 11 (95% CI, 3.5 to 34.8) during the third season. We observed significant effectiveness of the pentavalent rotavirus vaccine on the number of hospitalizations in a population of prematurely born infants younger than 3 years of age. A multicenter national study would provide better assessment of this impact. (This study [Impact of Systematic Infants Vaccination Against Rotavirus on Gastroenteritis Hospitalization: a Prospective Study in Brest District, France (IVANHOE)] has been registered at ClinicalTrials.gov under registration no. NCT00740935.).

Copyright © 2014, American Society for Microbiology. All Rights Reserved.

Figures

FIG 1

Numbers of hospitalized infants living within the catchment area of Brest University Hospital and hospitalized for rotavirus-specific diarrhea according to age groups during five epidemics (2002-2003 to 2006-2007) before vaccine introduction.

FIG 2

Number of infants vaccinated between May 2007 and May 2010, including those born at Brest University Hospital.

FIG 3

Observed and expected hospitalizations for rotavirus diarrhea during epidemic seasons.

FIG 4

Serious adverse events (SAEs) reported from May 2007 to May 2010. The analysis was not restricted to the catchment area of Brest University Hospital.