A case-control study of risk factors for intussusception among infants in eastern France after the introduction of the rotavirus vaccine

Vaccine. 2019 Jul 26;37(32):4587-4593. doi: 10.1016/j.vaccine.2019.02.053. Epub 2019 Mar 7.

Abstract

Objective: The objective of the present study was to investigate the risk factors for intussusception (IS) among infants, including vaccination against rotavirus.

Methods: Case-control study with systematic inclusion of all infants aged <1 year with suspected IS admitted to emergency departments in the eastern region of France between 1 April 2008 and 31 March 2012. All cases classed level 1 according to the Brighton classification were matched to 4 hospital controls. Two exposure windows were examined; exposure to the first dose of rotavirus vaccine in the 7 and in the 14 days prior to the occurrence of IS.

Results: A total of 115 cases were matched with 457 controls. The average vaccination coverage rate over the 4 years of study was 8.6%. Rotavirus vaccine was not found to be significantly associated with the occurrence of IS in the 7 days (odds ratio (OR) not calculated; p = 0.99) and in the 14 days after administration of one dose vaccine (OR 1.33, 95% confidence interval (CI) 0.14-12.82). Infant formula alone or combined with breastfeeding was associated with an excess risk of IS (OR 2.74, 95% CI 1.10-6.79). A history of gastroenteritis within 2 weeks prior to hospitalisation was also associated with an increased risk (OR 2.24, 95% CI 1.07-4.67).

Conclusion: Our study indicates that infant formula alone or combined with breastfeeding is a risk factor for IS. A small, non-significant increase in the risk of IS was observed after rotavirus vaccination, although the low vaccine coverage rate likely precluded detection of a significant increase in risk.

Keywords: Case-control study- rotavirus vaccine; Infants; Intussusception; Risk factors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Breast Feeding / methods
  • Case-Control Studies
  • Female
  • France
  • Gastroenteritis / chemically induced
  • Hospitalization
  • Humans
  • Infant
  • Infant, Newborn
  • Intussusception / chemically induced*
  • Male
  • Odds Ratio
  • Risk Factors
  • Rotavirus / immunology
  • Rotavirus Infections / immunology
  • Rotavirus Vaccines / adverse effects*
  • Rotavirus Vaccines / immunology
  • Vaccination / adverse effects*
  • Vaccines, Attenuated / adverse effects
  • Vaccines, Attenuated / immunology

Substances

  • Rotavirus Vaccines
  • Vaccines, Attenuated