Evaluation of Intussusception after Monovalent Rotavirus Vaccination in Africa.
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Tate Jacqueline E, Mwenda Jason M, Armah George, Jani Bhavin, Omore Richard, Ademe Ayesheshem, Mujuru Hilda, Mpabalwani Evans, Ngwira Bagrey, Cortese Margaret M, Mihigo Richard, Glover-Addy Hope, Mbaga Mwajabu, Osawa Francis, Tadesse Amezene, Mbuwayesango Bothwell, Simwaka Julia, Cunliffe Nigel, Lopman Benjamin A, Weldegebriel Goitom, Ansong Daniel, Msuya David, Ogwel Billy, Karengera Thomas, Manangazira Portia, Bvulani Bruce, Yen Catherine, Zawaira Felicitas R, Narh Clement T, Mboma Lazaro, Saula Peter, Teshager Fasil, Getachew Halle, Moeti Rebecca M, Eweronu-Laryea Christabel, Parashar Umesh D, African Intussusception Surveillance Network
Аннотация
METHODS: Using active surveillance, we enrolled patients from seven countries (Ethiopia, Ghana, Kenya, Malawi, Tanzania, Zambia, and Zimbabwe) who had intussusception that met international (Brighton Collaboration level 1) criteria. Rotavirus vaccination status was confirmed by review of the vaccine card or clinic records. The risk of intussusception within 1 to 7 days and 8 to 21 days after vaccination among infants 28 to 245 days of age was assessed by means of the self-controlled case-series method.
RESULTS: Data on 717 infants who had intussusception and confirmed vaccination status were analyzed. One case occurred in the 1 to 7 days after dose 1, and 6 cases occurred in the 8 to 21 days after dose 1. Five cases and 16 cases occurred in the 1 to 7 days and 8 to 21 days, respectively, after dose 2. The risk of intussusception in the 1 to 7 days after dose 1 was not higher than the background risk of intussusception (relative incidence [i.e., the incidence during the risk window vs. all other times], 0.25; 95% confidence interval [CI], <0.001 to 1.16); findings were similar for the 1 to 7 days after dose 2 (relative incidence, 0.76; 95% CI, 0.16 to 1.87). In addition, the risk of intussusception in the 8 to 21 days or 1 to 21 days after either dose was not found to be higher than the background risk.
CONCLUSIONS: The risk of intussusception after administration of monovalent human rotavirus vaccine was not higher than the background risk of intussusception in seven lower-income sub-Saharan African countries. (Funded by the GAVI Alliance through the CDC Foundation.).