Wednesday, February 20, 2013

Preventing Rotavirus with Vaccines: Do They Work?

In a prior blog entry, research was discussed on the best evidence for treatment of acute gastroenteritis (also known as the stomach bug/stomach flu). Common signs and symptoms of gastroenteritis include diarrhea, stomach pain, stomach cramps, and vomiting. When it occurs in children, it is usually caused by a virus known as rotavirus (pictured above).

By age five, nearly every child in the world has been infected by rotavirus at least once. If there was a way to prevent children from getting rotavirus in the first place, it would prevent millions of children from suffering  and save millions of dollars in hospital care. Fortunately, there is a way to do this via the rotavirus vaccine, which was introduced as a routine vaccination in 2006 in the United States. There are two such rotavirus vaccines currently available (Rotarix and RotaTeq) but more are being developed.  A prior rotavirus vaccine known as RotaShield was taken off the U.S. market in 1999 because it caused bowel obstructions.

As predicted, gastroenteritis has been significantly reduced with the implementation of these vaccinations across the world. However, many children still become sick due to rotavirus because many children do not receive the vaccine and about 13% of pediatricians do not offer it.  Increased compliance with rotavirus vaccination can occur through increased education.

In the current issue of the Annual Review of Medicine, the current state of the evidence on the use of rotavirus vaccines in children was reviewed positively but the author of the article was a former employee of Merck who was involved in the development of Rotateq. For those who would prefer a more independent scientific review of the Rotavirus vaccine, one of the highest standards is a Cochrane review. A Cochrane review is an independent evidenced-based scientific review by the Cochrane Collaboration, which is composed of volunteer experts. The results of a recent Cochrane review showed that Rotarix and RotaTeq are considered to be safe vaccines based on studies with close to 200,000 children. Thus, talking about the Rotavirus vaccine with your pediatrician is a good idea if you have not already done so.

Suggested reading: Viral Gastroenteritis
Related blog entry: The Stomach Bug/Flu in Children: What Works and What Doesn’t

References: Shaw AR. (2013). The rotavirus saga revisited. Annu Rev Med. 64:165-74. Soares-Weiser K, Maclehose H, Bergman H, Ben-Aharon I, Nagpal S, Goldberg E, Pitan F, Cunliffe N. (2012). Vaccines for preventing rotavirus diarrhoea: vaccines in use.Cochrane Database Syst Rev. (2012)

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