Evaluating the potential risks and benefits of infant rotavirus vaccination in England

Andy Clark, Mark Jit, Nick Andrews, Christina Atchison, W. John Edmunds, Colin Sanderson

Research output: Contribution to journalArticlepeer-review

Abstract

Rotarix®, a vaccine for the prevention of gastroenteritis in young children, was introduced in England in July 2013. At around this time, an elevated risk of intussusception (a cause of bowel obstruction) was reported among infants vaccinated in Australia and the USA. A risk-benefit analysis compared potential vaccine-related risks (additional intussusception admissions and deaths) with estimated vaccine benefits (prevented rotavirus general practitioner visits, emergency visits, admissions and deaths) in the 2012 birth cohort. Detailed data from England included the incidence of intussusception events aged <2 years by week of age, the coverage of vaccination aged <2 years by week of age, and the incidence of rotavirus gastroenteritis (RVGE) events aged <5 years by week of age. Recent estimates of vaccine-related risk from Australia were applied during the 1-21 day period after the first and second dose of vaccination. Rotarix® is estimated to cause one additional intussusception admission in every 18,551 vaccinated English infants (5th and 95th percentiles, 6728-93,952), equivalent to 35 (7-98) additional intussusception admissions each year. The vaccine is estimated to prevent three rotavirus deaths, 13,000 rotavirus admissions, 27,000 rotavirus emergency visits and 74,000 rotavirus GP consultations in children aged <5 years, and lead to annual savings of over £11 million, each year. We estimate 375 (136-1900) fewer RVGE admissions for every additional intussusception admission, and 88 (18-852) fewer RVGE deaths for every additional intussusception death. The estimated benefits of Rotarix® vaccination would greatly exceed the potential risk in England.

Original languageEnglish (US)
Pages (from-to)3604-3610
Number of pages7
JournalVaccine
Volume32
Issue number29
DOIs
StatePublished - Jun 17 2014

Keywords

  • Intussusception
  • Risk-benefit analysis
  • Rotavirus
  • Vaccination

ASJC Scopus subject areas

  • Molecular Medicine
  • General Immunology and Microbiology
  • General Veterinary
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Fingerprint

Dive into the research topics of 'Evaluating the potential risks and benefits of infant rotavirus vaccination in England'. Together they form a unique fingerprint.

Cite this