Rotavirus vaccination and intussusception: a paradigm shift?

ABSTRACT

Rotavirus (RV) is one of the leading causes of severe childhood gastroenteritis in children <5 years of age. Several countries have successfully implemented vaccination against RV disease; however, hesitancy to include RV vaccination in the national immunization program exists and relates, among other reasons, to the results of international post-licensure studies of RV vaccines that established an increased risk of intussusception (IS) in infants following immunization. IS is one of the major causes of bowel obstruction in infants between 4 and 10 months of age. Some studies have investigated the etiology of IS, including the role of natural RV infection and available evidence suggests that RV disease may be an independent risk factor for IS. In this regard, the benefit-risk profile of RV vaccination, which is recognized as positive, could potentially turn out to be even more favorable in preventing IS cases triggered by RV disease. However, further research is prompted to quantify the IS risk attributable to RV disease.

KEYWORDS:

• Rotavirus
• gastroenteritis
• intussusception
• bowel obstruction
• vaccination

Acknowledgments

The Authors acknowledge Catherine Cohet, Corinne Willame, Emmanuel Aris, Leentje Moerman and Tina Singh for their critical review of the manuscript. The authors also thank the Modis platform for editorial assistance and manuscript coordination, on behalf of GSK. Anne-Theres Henze provided medical writing support and Emmanuelle Ghys coordinated the manuscript development and editorial support.

Disclosure of potential conflicts of interest

VV, PP, and BB are employed by and hold shares in the GSK group of companies.

Trademark statements

Rotarix is a trademark owned by the GSK group of companies. RotaTeq is a registered trademark of Merck&Co., Inc. Rotavac is a trademark of Bharat Biotech.

Additional information

Funding

This work was supported by GlaxoSmithKline Biologicals SA, which was the funding source;