PEDIATRICS Vol. 108 No. 2 August 2001, p. e37
ELECTRONIC ARTICLE:
Intussusception, Infection, and Immunization: Summary of
a Workshop on Rotavirus
Received Jan 20, 2001; accepted Apr 4, 2001.
,
, and
From the * National Vaccine Program Office, Atlanta, Georgia;
This article summarizes the proceedings of a
workshop sponsored by the National Institutes of Health and the
National Vaccine Program Office, and held in Bethesda, Maryland, on
January 21, 2000. The objective of the meeting was to focus research
toward an understanding of the basis for the possible association
between intussusception and the reassortant rhesus-human rotavirus
vaccine tetravalent (RRV-TV). After numerous reports of intussusception after administration of RRV-TV, the manufacturers of this vaccine voluntarily withdrew it from the United States market. The American Academy of Pediatrics, the Advisory Committee on Immunization Practices, and the American Academy of Family Physicians also withdrew
their original recommendations for administration of RRV-TV to children
at 2, 4, and 6 months of age. These actions will have global
implications for the prevention of morbidity and mortality attributable
to rotavirus infection. Benefit-cost ratios for the use of RRV-TV will
be substantially different in developing countries compared with
developed countries. Therefore, extensive research is needed in both of
these settings, to further our understanding of the epidemiology,
pathogenesis, and pathology of both rotavirus disease and
intussusception to enable optimal prevention. The workshop reviewed the
current understanding of the possible association between RRV-TV and
intussusception, as well as the possible association between a variety
of viral infections and intussusception. The workshop also identified
critical areas of research regarding this possible association. This
research will be essential not only for the development of safe and
effective rotavirus vaccines, but for the development of other oral
vaccines as well.
National Institute of Allergy and Infectious Disease, National
Institutes of Health, Bethesda, Maryland; § National Immunization
Program, Centers for Disease Control and Prevention, Atlanta, Georgia;
Center for Biologics Evaluation and Research, United States Food and
Drug Administration, Bethesda, Maryland; and ¶ National Center for
Infectious Diseases, Centers for Disease Control and Prevention,
Atlanta, Georgia.
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