What is the role of rotavirus vaccine in the etiology of intussusception?

Updated: Dec 20, 2018
  • Author: A Alfred Chahine, MD; Chief Editor: Carmen Cuffari, MD  more...
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An association was found between the administration of a rotavirus vaccine (RotaShield) and the development of intussusception. [10] RotaShield has since been removed from the market. These patients were younger than usual for idiopathic intussusception and were more likely to require operative reduction. It was hypothesized that the vaccine caused reactive lymphoid hyperplasia, which acted as a lead point.

In February 2006, a new rotavirus vaccine [RotaTeq] was approved by the US Food and Drug Administration [FDA]. RotaTeq did not show an increased risk for intussusception compared with placebo in clinical trials. [11] A study that involved more than 63,000 patients who received Rotarix or placebo at ages 2 and 4 months reported a decreased risk for intussusception in those patients receiving Rotarix. [12]  However, a 2015 study reported that there was a small increase in the risk of intussusception hospitalizations in infants in California since the introduction of rotavirus vaccines, RotaTeq (2006) and Rotarix (2008). [13, 14]   

A study by Tate et al that analyzed the intussusception hospitalization rates before (2000–2005) and after (2007–2013) rotavirus vaccine introduction reported that when compared to the prevaccine baseline (11.7 per 100,000), the intussusception hospitalization rate significantly increased by 46% to 101% (16.7-22.9 per 100,000) in children 8-11 weeks of age in the years after the rotavirus vaccine was introduced. No significant change in hospitalization rates were seen in children 15</ref>

Analysis of data from the Kid’s Inpatient Database in the United States has shown a lower than expected rate of hospital discharges for intussusception in infants since the reintroduction of the rotavirus vaccine in 2006. [16]

Familial occurrence of intussusception has been reported in a few cases. Intussusception in dizygotic twins has also been described; however, these reports are extremely rare.

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