Rotavirus

This is by far my favorite childhood vaccine for the simple reason that it comes in the form of a yummy syrup that babies can swallow and doesn’t involve mean pokey needles. Also one of its formulators is the great Paul Offit and I think he’s pretty rad so yay rota vaccine! What’s rotavirus? In medical school we learn that you can remember what rota does to you by how it’s spelled – R O T A – right out the anus. This nasty virus causes MASSIVE diarrhea, to the point that babies become dangerously dehydrated. In the US, they get admitted to the hospital and get IV fluids. In the developing world, if they don’t have access to a hospital, death is a real possibility. The mortality rate of rotavirus isn’t that high, but the burden of disease is HUGE. Before the introduction of the modern vaccine in 2006, 4 out of 5 children would experience symptomatic infection sometime before kindergarden. One in 7 would be sick enough to seek emergency care and one in 70 would be sick enough to require hospitalization. One in 200,000 would die . . . in the 21st century in the United States. Post vaccine, hospitalization rates are down 87-96% depending on which study you read. The efficacy of this one is about 85% for babies who receive all doses. Other reasons I like to talk about this vaccine – notice how it wasn’t introduced until 2006 and before that time, it was still a major problem, despite modern water treatment and hygiene practices. You can’t claim this one was wiped out because of better sanitation. Rotavirus is also a really nice example of how vaccine safety surveillance works. The FIRST rotavirus vaccine was actually licensed and put into use in 1998. The good folks at VAERS (the vaccine adverse event reporting service) almost immediately noticed a significant uptick in reported cases of intussusception in infants under 3 months of age. This is unusual since this condition usually seen in older babies. VAERS was all over it. Their scientists collected data, ran the numbers, concluded that there was indeed a causative association and the vaccine was pulled from the market less than a year later. The manufacturer lost a lot of money because of that but you know what? The CDC and the pediatric community didn’t care. They did the right thing to take care of kids. Because they don’t actually work for big pharma. The modern vaccine that was licensed in 2006 has no such association. VAERS still sees some reported cases of intussusception soon after administration of the vaccine, but the rates are similar to baseline rates that were established before its introduction so we can conclude that these are coincidental. That’s how safety monitoring works, folks.
http://www.mayoclinic.org/diseases-conditions/…/ovc-20186926
http://www.cdc.gov/vacc…/…/surv-manual/chpt13-rotavirus.html
This is a study published in 2003, before introduction of the vaccine – http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2972763/
On the effectiveness of the vaccine – http://ije.oxfordjournals.org/content/39/suppl_1/i56.full
And history of the vaccine – http://www.historyofvaccines.org/content/articles/rotavirus

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