NICU Babies More Likely to Miss Rotavirus Vax

Introducción

For U.S. kids born after the rotavirus vaccine was introduced, recommendations against administration in the neonatal intensive care unit (NICU) appeared to be a strong barrier to getting immunized, researchers reported.

Children most likely to not receive a first rotavirus vaccine dose included those with extremely preterm birth (OR 14.6, 95% CI 11.2-20.0), birth soon after introduction of the vaccine (OR 3.3, 95% CI 2.9-3.8), and lack of health insurance (OR 2.2, 95% CI 1.8-2.7), noted Mary Moran, PhD, MPH, of the CDC, and colleagues, in Pediatrics.

Recomendaciones de Vacunación

The CDC’s Advisory Committee on Immunization Practices (ACIP) and the American Academy of Pediatrics (AAP) have recommended a maximum age for a first rotavirus vaccine dose of 14 weeks and 6 days and full series completion by 8 months of age, the research team noted.

However, ACIP guidelines have recommended NICU patients who are age-eligible not receive the shot until discharge due to a theoretic risk of vaccine virus transmission within the NICU, although AAP guidelines note that hospitals may consider giving the shot to otherwise eligible infants in the NICU, Moran and colleagues continued.

Impacto en la Vacunación

In an examination of NICU details for 230 extremely preterm infants who received diphtheria, tetanus, and pertussis (DTaP) vaccination, more than half were not discharged until at least 15 weeks. Of these infants, 80% did not receive the rotavirus shot.

Overall, kids who received a first dose of the DTaP vaccine at 15 weeks of age or older had greater odds of not receiving a first rotavirus vaccine dose (OR 30.0, 95% CI 26.8-33.7) or not finishing the series (OR 6.6, 95% CI 5.7-7.8) compared with those who received the DTaP vaccine before 15 weeks.

Among kids 8 months of age or older, risk factors associated with the greatest odds of not completing the rotavirus vaccine series were receipt of first dose at 15 weeks or older (OR 18.8, 95% CI 15.9-22.3), extremely preterm birth (OR 4.9, 95% CI 2.6-5.2), lack of health insurance (OR 3.2, 95% CI 2.5-4.1) or public insurance (OR 2.2, 95% CI 1.9-2.4), and a household income of $25,000 or less (OR 2.3, 95% CI 2.0-2.6).

Conclusiones y Consideraciones Futuras

Despite suboptimal vaccination coverage, the progress that has been made in rotavirus vaccination has led to dramatic decreases in rotavirus hospitalizations in the United States.

Before widespread rotavirus vaccine use, each year saw 55,000 to 70,000 infant hospitalizations and 50 to 100 deaths related to rotavirus. In recent years, hospitalizations have dropped by about 80%, and deaths have been rare.

Aviso legal

Este contenido es solo para fines informativos y no debe considerarse como un consejo médico. Siempre consulte a un profesional de la salud para obtener orientación sobre el cuidado médico y la vacunación.

Fuente: https://www.medpagetoday.com/pediatrics/vaccines/121661