Study shows vaccination decreases rotavirus rates

HOUSTON - (Jan. 12, 2015) - A new study by Baylor Collegeof Medicine and Texas Children's Hospital researchers shows that a vaccine forrotavirus in infants reduces the rates of infection.

In the study of children enrolled in an acutegastroenteritis (AGE) surveillance program, researchers found that healthcareproviders who administered rotavirus vaccines to more of their patients sawlower rates of rotavirus infection than those who did not. Their report appearstoday in the journal Pediatrics.

"This shows that there is an association between notbeing vaccinated and getting the disease," said Leila Sahni, immunizationaction plan coordinator at Texas Children's and first author of the paper.

Rotavirus is a common case of childhood diarrhea and vomitingand a major cause of mortality in middle and low-income countries. Rotavirusvaccines were first introduced in the United States in 2006 and have a narrowage range during which they can be given. Infants must receive the first doseof this oral vaccine at their two-month visit. Researchers at Baylor and TexasChildren's have been monitoring patients who arrive at the Texas Children'semergency center with AGE and noticed that a high proportion ofrotavirus-positive cases were occurring among patients from a small number ofindividual provider locations.

They hypothesized that the vaccination coverage rates atthese sites might be associated with the proportion of rotavirus-positive casesfrom that provider location.

Over a two-year period, researchers reviewed vaccinationrecords for infants who came into the emergency room with AGE and determinedwhich providers in the city had low coverage (less than 40 percent), mediumcoverage (40 to 79 percent) or high coverage (80 percent or more) for the rotavirusvaccine amongst their patients. They found that a little over 80 percent ofpatients in the surveillance program had received the rotavirus vaccine from 68different locations. Of these locations, four locations were classified as lowcoverage, 22 were medium coverage and 42 were high coverage for the vaccine. Patientscared for by pediatricians at low-coverage locations had 31.4 percent of allrotavirus-positive patients compared to 13.1 percent and 9.6 percent in themedium and high-coverage locations, respectively. Patients from low-coveragelocations were 3 times more likely to have rotavirus than patients fromhigh-coverage locations

Of the four low-coverage locations, one was a neonatalintensive care unit, or NICU. The rotavirus vaccine is not administered inNICUs because it is a live vaccine that is given orally. The vaccine is notgiven to premature infants, and some remain in the NICU for the entire windowduring which the first dose of vaccine can be administered (up to 14 weeks andsix days). Those infants who are discharged from the NICU before this time canreceive the vaccine upon discharge.

Sahni notes the importance of providers administeringthis vaccine during the two-month visit and for parents to be aware of it.

"It's the only vaccine that is given by mouth, so parentsshould ask about it during the two-month visit if they notice that their childdid not receive it," said Sahni.

Others who took part in the study include Dr. Julie A.Boom of Baylor and Texas Children's and Dr. Jacqueline E. Tate, Dr. Daniel C.Payne and Dr. Umesh D. Parashar of the Centers for Disease Control andPrevention.

The study was supported by a Centersfor Disease Control and Prevention grant awarded to the Texas Department ofState Health Services (CDC-RFA-CI07-70405ARRA09).

About Texas Children’s Hospital

Texas Children’s Hospital, a not-for-profit health care organization, is committed to creating a healthier future for children and women throughout the global community by leading in patient care, education and research. Consistently ranked as the best children’s hospital in Texas, and among the top in the nation, Texas Children’s has garnered widespread recognition for its expertise and breakthroughs in pediatric and women’s health. The hospital includes the Jan and Dan Duncan Neurological Research Institute; the Feigin Center for pediatric research; Texas Children’s Pavilion for Women, a comprehensive obstetrics/gynecology facility focusing on high-risk births; Texas Children’s Hospital West Campus, a community hospital in suburban West Houston; and Texas Children’s Hospital The Woodlands, a second community hospital planned to open in 2017. The organization also created the nation’s first HMO for children, has the largest pediatric primary care network in the country and a global health program that’s channeling care to children and women all over the world. Texas Children’s Hospital is affiliated with Baylor College of Medicine. For more information, go to www.texaschildrens.org. Get the latest news by visiting the online newsroom and Twitter at twitter.com/texaschildrens.