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The first oral rotavirus vaccine, 1998-1999: estimates of uptake from the National Immunization Survey

Philip J Smith1, Ben Schwartz, Ali Mokdad

  • 1National Immunization Program, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. PSmith3@cdc.gov

Public Health Reports (Washington, D.C. : 1974)
|April 12, 2003
PubMed

Insights

The rhesus-human reassortant rotavirus vaccine (RRV-TV) showed varied uptake rates. This study highlights challenges in linking vaccines to rare adverse events like intussusception.

Area of Science:

  • Vaccinology
  • Pediatric Public Health
  • Epidemiology

Background:

  • The rhesus-human reassortant rotavirus vaccine (RRV-TV) was licensed in the U.S. in 1998.
  • Post-licensure surveillance identified potential associations between RRV-TV and intussusception.
  • Conflicting results from early case-control/cohort versus later ecologic studies necessitated further investigation into vaccine uptake.

Purpose of the Study:

  • To estimate state and national RRV-TV uptake rates using National Immunization Survey (NIS) data.
  • To identify demographic and socioeconomic factors associated with RRV-TV receipt.
  • To provide crucial data for evaluating ecologic studies on RRV-TV and intussusception.

Main Methods:

  • Analysis of NIS data for children aged 19-35 months eligible for RRV-TV between September 1998 and July 1999.
  • Estimation of vaccine coverage and doses administered by state, quarter, and birth cohort.
  • Statistical analysis of demographic and socioeconomic variables in relation to vaccine uptake.

Main Results:

  • Approximately 1 million doses of RRV-TV were administered to over 500,000 eligible children, representing 13.4% uptake.
  • Significant state-to-state variation in RRV-TV administration and coverage rates was observed.
  • Children from higher socioeconomic households demonstrated a greater likelihood of receiving the RRV-TV vaccine.

Conclusions:

  • Ecologic studies faced limitations in detecting RRV-TV's impact on intussusception due to low vaccine coverage in study populations.
  • Assessing the association between vaccines and rare adverse events presents significant methodological challenges.
  • The RRV-TV case illustrates difficulties in evaluating vaccine safety for uncommon adverse events.
Abstract

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