Impact of rotavirus vaccination on intussusception hospital admissions in England

Luke J McGeoch; Adam Finn; Robin D Marlow

doi:10.1016/j.vaccine.2020.06.078

Impact of rotavirus vaccination on intussusception hospital admissions in England

Vaccine. 2020 Jul 31;38(35):5618-5626. doi: 10.1016/j.vaccine.2020.06.078. Epub 2020 Jul 10.

Authors

Luke J McGeoch¹, Adam Finn², Robin D Marlow³

Affiliations

¹ Population Health Sciences, University of Bristol, Bristol, UK. Electronic address: lukemcgeoch@doctors.org.uk.
² Population Health Sciences, University of Bristol, Bristol, UK; School of Cellular and Molecular Medicine , University of Bristol, Bristol, UK; NIHR Health Protection Research Unit in Evaluation of Interventions, University of Bristol, Bristol, UK.
³ Population Health Sciences, University of Bristol, Bristol, UK; NIHR Health Protection Research Unit in Evaluation of Interventions, University of Bristol, Bristol, UK; Paediatric Emergency Department, Bristol Royal Hospital for Children, Bristol, UK.

PMID: 32654906
DOI: 10.1016/j.vaccine.2020.06.078

Abstract

Background: An increased risk of intussusception has been reported following rotavirus vaccination. We sought to determine whether introduction of rotavirus vaccination in England in July 2013 was associated with a change in the burden of total and age group-specific childhood hospital admissions for intussusception.

Methods: We identified all children aged 0-36 months admitted to hospitals in England with intussusception using the Hospital Episode Statistics dataset. We performed a retrospective ecological analysis comparing hospital admission rates for intussusception during the periods before (2008/2009-2012/2013) and after (2014/2015-2017/2018) introduction of rotavirus vaccination using modified Poisson regression and interrupted time series analysis. Length of hospital stay and clinical outcomes were also examined.

Results: The mean annual admission rate for intussusception in infants over the ten-year study period was 31.5 per 100,000 person-years. An increase in the admission rate in the 8-16 weeks age group (RR 1.46, 95% CI 1.12-1.91), those receiving vaccination, was compensated for by decreases in the 17-24 weeks (RR 0.77, 0.63-0.94), 25-32 weeks (RR 0.71, 0.59-0.86) and 41-52 weeks (RR 0.80, 0.66-0.98) age groups. Using interrupted time series analysis, we observed a significant decrease in incidence in the 0-12 months age group (RR 0.80, 0.67-0.96), but not in the overall 0-36 months age group (RR 1.09, 0.98-1.20). There was no significant change in the proportion of children requiring surgical intervention or with major complications of intussusception. Length of hospital stay decreased among infants receiving surgery for intussusception.

Conclusions: Our results suggest that introduction of rotavirus vaccination in England has resulted in a downward shift in the age at which intussusception occurs in infants, with no overall increase in hospital admission rate or disease severity. These findings support the view that the benefits of rotavirus vaccination outweigh the small increased risk of intussusception in the early post-vaccination period.

Keywords: Gastroenteritis; Intussusception; Rotavirus; Vaccine.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Child
Child, Preschool
England / epidemiology
Hospitalization
Hospitals
Humans
Infant
Infant, Newborn
Intussusception* / chemically induced
Intussusception* / epidemiology
Retrospective Studies
Rotavirus Infections* / epidemiology
Rotavirus Infections* / prevention & control
Rotavirus Vaccines* / adverse effects
Rotavirus*
Vaccination
Young Adult

Substances

Rotavirus Vaccines