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Evaluating the potential risks and benefits of infant rotavirus vaccination in England

Andy Clark1, Mark Jit2, Nick Andrews3

  • 1Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK.

Vaccine
|May 13, 2014
PubMed

Insights

Rotarix® vaccination for infants offers significant benefits, preventing thousands of rotavirus cases and saving lives, despite a small increased risk of intussusception. The overall benefits of this gastroenteritis vaccine greatly outweigh potential risks.

Area of Science:

  • Pediatric Vaccinology
  • Public Health
  • Epidemiology

Background:

  • Rotarix® is a vaccine for preventing rotavirus gastroenteritis (RVGE) in children.
  • Concerns regarding an elevated risk of intussusception, a bowel obstruction, were raised following its introduction in England in 2013.
  • Previous reports from Australia and the USA indicated a potential association between vaccination and intussusception.

Purpose of the Study:

  • To conduct a risk-benefit analysis of Rotarix® vaccination in England.
  • To compare the estimated vaccine-related risks (intussusception) with the benefits (prevented rotavirus illness).

Main Methods:

  • Utilized detailed English data on intussusception incidence, vaccination coverage, and rotavirus gastroenteritis (RVGE) incidence.
  • Applied risk estimates from Australian studies for the period following vaccination.
  • Calculated additional intussusception admissions and deaths versus prevented RVGE events and deaths.

Main Results:

  • Rotarix® is estimated to cause one additional intussusception admission per 18,551 vaccinated infants annually in England.
  • The vaccine is projected to prevent approximately 3 rotavirus deaths, 13,000 admissions, 27,000 emergency visits, and 74,000 GP consultations each year.
  • Estimated savings exceed £11 million annually, with significantly more RVGE admissions and deaths prevented than intussusception events.

Conclusions:

  • The benefits of Rotarix® vaccination in England are estimated to substantially outweigh the potential risks.
  • The vaccine demonstrates a favorable risk-benefit profile for preventing rotavirus gastroenteritis in young children.
  • Public health recommendations should consider the significant protective effects against rotavirus disease.

Keywords:
IntussusceptionRisk-benefit analysisRotavirusVaccination

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