Lives could be saved by removing age restrictions on rotavirus vaccination

Press release from PLOS Medicine

2012-10-24

(Press-News.org) Lives could be saved by removing age restrictions on rotavirus vaccination

A study published in this week's PLOS Medicine, which suggests that the additional children's lives saved by removing the age restrictions for rotavirus vaccination in low- and middle-income countries would be much greater than any extra deaths from vaccine-associated complications (namely, intussusception-a form of bowel obstruction), has informed policy regarding the age restrictions for this vaccine.

Hundreds of thousands of infants world-wide have been vaccinated against rotavirus (which causes vomiting and diarrhea and can kill young children) but this vaccine can slightly increase the risk of intussusception, with some countries reporting a risk of 1-4 additional cases per 100,000 vaccinated infants. As older infants have a higher risk of naturally occurring intussusception, the World Health Organization previously decided that the course of rotavirus vaccination should be initiated before the age of 15 weeks and completed before the age of 32 weeks. In poorer countries, where access to health facilities is more difficult, this age restriction could exclude many eligible infants from being vaccinated against rotavirus because of delays in the vaccination program.

In a modelling study, the authors from the Centers for Disease Control and Prevention and the London School of Hygiene and Tropical Medicine analysed the benefits and risks of rotavirus vaccination if the age restrictions were removed, and the rotavirus vaccine given to children alongside other routine childhood immunizations.

Using their model, the authors found that that in low-and low-middle income countries, keeping the age restrictions would prevent 155,800 rotavirus deaths, while potentially causing 253 deaths from intussusception. However, lifting the age restrictions would prevent 203,000 rotavirus deaths while potentially causing 547 intussusception deaths. Overall, the authors found that lifting the age restriction would result in an additional 47,200 deaths from rotavirus prevented versus 294 intussusception deaths caused, translating to 154 deaths prevented for every death caused by complications of the vaccine.

Experts from the World Health Organization reviewed the results from this study and while still encouraging timely vaccination, the World Health Organization no longer universally recommends age restrictions and supports removing age restrictions in settings where the benefits outweigh the risks.

The authors say: "Our analysis suggests that in low- and middle-income countries the additional lives saved by removing age restrictions for rotavirus vaccination would far outnumber the potential excess vaccine-associated intussusception deaths."

The authors continue: "Age restriction policies will ultimately be decided at country level, but this analysis has shown a clear case for a change in policy that will be particularly instrumental for saving lives in settings where mortality from rotavirus is high and delays in timing of vaccination are common."

### Funding: CS has received salary support from WHO's Initiative for Vaccine Research for collecting some of the data (vaccine timeliness and age distribution of rotavirus deaths) used in the model. AC was funded by PanAmerican Health Organization's ProVac Initiative. MMP, UDP, and JT were personally salaried by their institutions during the period of writing (though no specific salary was set aside or given for the writing of this paper). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the US Centers for Disease Control and Prevention (CDC).

Competing Interests: The authors have declared that no competing interests exist.

Citation: Patel MM, Clark AD, Sanderson CFB, Tate J, Parashar UD (2012) Removing the Age Restrictions for Rotavirus Vaccination: A Benefit-Risk Modeling Analysis. PLoS Med 9(10): e1001330. doi:10.1371/journal.pmed.1001330

IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER (THIS LINK WILL BECOME LIVE WHEN THE EMBARGO LIFTS):

http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001330

CONTACT:

Jeanette St. Pierre
zcr5@cdc.gov
404.639.3648 END

ELSE PRESS RELEASES FROM THIS DATE:

Provider-initiated HIV testing does not affect clients' rights

2012-10-24

A new study reported in this week's PLOS Medicine reports findings from a study carried out in four African countries by Carla Makhlouf Obermeyer and colleagues on approaches towards expanding testing and counselling for HIV. Provider-initiated HIV testing has the potential to expand access to treatment and prevention services, but there have been concerns as to whether consent practices, client confidentiality, and the referral to care will be acceptable under provider-initiated testing modes. The study, conducted in Burkina Faso, Kenya, Malawi and Uganda, found that ...

Product regulatory systems in low-and middle-income countries must be strengthened

2012-10-24

When regulatory systems for medical products in low-and middle-income countries work, people live but when such systems fail, people die, according to experts from the US Food and Drug Administration (FDA) writing in this week's PLOS Medicine. Charles Preston, Mary Lou Valdez, and Katherine Bond from the Office of International Programs at the FDA, argue that few global initiatives focus on strengthening the medical product regulatory systems in low-and middle-income countries but that globalization and the scaling up of medicines and vaccines to these countries are highlighting ...

Increased use of colonoscopy screening could explain decrease in colorectal cancer rates

2012-10-24

STANFORD, Calif. — Use of colonoscopy for colorectal cancer screening could explain a significant decrease in the cancer's incidence over the past decade, according to a new study from researchers at the Stanford University School of Medicine. Although colonoscopy is now the most common colorectal cancer screening method, there has been conflicting evidence as to its effectiveness compared with sigmoidoscopy, a method that examines only a portion of the colon. The team scrutinized data collected from more than 2 million patients over the past 20 years, and found that ...

Grandmas made humans live longer

2012-10-24

SALT LAKE CITY, Oct. 24, 2012 – Computer simulations provide new mathematical support for the "grandmother hypothesis" – a famous theory that humans evolved longer adult lifespans than apes because grandmothers helped feed their grandchildren. "Grandmothering was the initial step toward making us who we are," says Kristen Hawkes, a distinguished professor of anthropology at the University of Utah and senior author of the new study published Oct. 24 by the British journal Proceedings of the Royal Society B. The simulations indicate that with only a little bit of grandmothering ...

Genetic marker for placebo response identified in IBS patients

2012-10-24

BOSTON – Although placebos have played a critical role in medicine and clinical research for more than 70 years, it has been a mystery why these inactive treatments help to alleviate symptoms in some patients – and not others. Now researchers have for the first time identified genetic differences between placebo responders and non-responders, providing an important new clue to what has come to be known as "the placebo effect." Led by investigators at Beth Israel Deaconess Medical Center (BIDMC) and Harvard Medical School (HMS), the new findings demonstrate that genetic ...

Formula unlocks secrets of cauliflower's geometry

2012-10-24

The laws that govern how intricate surface patterns, such as those found in the cauliflower, develop over time have been described, for the first time, by a group of European researchers. In a study published today, 24 October, in the Institute of Physics and German Physical Society's New Journal of Physics, researchers have provided a mathematical formula to describe the processes that dictate how cauliflower-like patterns – a type of fractal pattern – form and develop. The term fractal defines a pattern that, when you take a small part of it, looks similar, although ...

Gene polymorphisms identified that are responsible for breast density and cancer risk

2012-10-24

It has long been known that breast density, or mammographic density, is a strong risk factor for breast cancer, and that estrogen and progestin hormone therapy increases dense breast tissue. Now, a study published in BioMed Central's open access journal Breast Cancer Research has identified several gene variants in hormone metabolism and growth factor pathways that may be associated with breast density and, hence, breast cancer risk. Mammographic density relates to the fact that x-rays permeate different types of breast tissue in different ways, leading to white areas ...

Acupuncture relieves symptoms of a dry mouth caused by radiotherapy for head and neck cancers

2012-10-24

Patients who have received radiotherapy for head and neck cancer often suffer from the unpleasant and distressing side-effect of a dry mouth, caused by damage to their salivary glands from the radiation. Now, a new study has shown that acupuncture can relieve the symptoms of dry mouth (known as xerostomia). The findings from the largest trial yet to investigate this are published in the cancer journal Annals of Oncology [1] today (Wednesday). Around half a million people worldwide develop head and neck cancer each year and, at present, there are few effective treatments ...

Hanging in there: Koalas have low genetic diversity

2012-10-24

A species relies on genetic diversity to survive and low diversity usually indicates that there has been inbreeding due to a decrease in population size. By looking at historic mitochondrial DNA (mtDNA) from museum samples, new research published in BioMed Central's open access journal BMC Genetics has found that koalas (Phascolarctos cinereus) have had low genetic diversity for over 120 years. The genetic diversity of koalas is known to be low in modern populations but historical reports suggest that koala populations have had a chequered past. When Europeans first ...

Personalized feedback makes healthcare workers twice as likely to clean their hands

2012-10-24

A major three-year trial led by researchers at UCL, in partnership with the Health Protection Agency, has shown that giving one-to-one feedback to healthcare workers makes them twice as likely to clean their hands or use soap. The Feedback Intervention Trial (FIT) is the first such trial to be done in a large number of hospitals anywhere in the world. Carried out across 60 wards in 16 hospitals that were already implementing the English and Welsh Cleanyourhands campaign, the study showed that an intervention that coupled feedback to personalised action planning improved ...

Lives could be saved by removing age restrictions on rotavirus vaccination

ELSE PRESS RELEASES FROM THIS DATE:

LAST 30 PRESS RELEASES: