Rotavirus Vaccine Risky For Infants with Immune Deficiency

A new study on the <"">rotavirus vaccine published in the New England Journal of Medicine has found that it can sicken severely immune-deficient infants. The study details three cases where such children actually developed rotaviral infection after vaccination.

Rotavirus is one of the most common causes of diarrhea, and the leading cause of severe, dehydrating diarrhea in infants and young children. Such infections cause approximately 3 million cases of diarrhea and 55,000 hospitalizations for diarrhea and dehydration in children under 5 years old each year in the United States. Rotavirus causes more than half a million deaths worldwide every year, mostly in developing countries where nutrition and healthcare are not optimal.

Rotavirus vaccine, which is administered in three doses between 6 and 32 weeks of age, is a live virus that has been weakened so that it does not present a threat of infection to children with normal immunity. However, according to researchers at Baylor University, that protection does not appear to extend to children born with severe combined immunodeficiency. Children with severe combined immunodeficiency lack protection provided by key components of the immune system – the T- and B-cells. As a result, these children have no protection against many infections that can become life-threatening.

In three cases detailed by the researchers, all of the infants received rotavirus vaccination before they were diagnosed with severe combined immunodeficiency. Analysis of the viral genetic material in stool specimens from the infants revealed that the virus they contracted originated with the vaccine. None of the children were able to fight off the rotavirus until they underwent bone marrow transplantation or enzyme replacement therapy that gave them a functioning immune system.

Current newborn screening does not test for severe combined immune deficiency, and in most cases, rotavirus vaccine must be given before children are diagnosed with this disorder. The American College of Medical Genetics recently recommended that severe combined immunodeficiency be included as a part of the newborn screen.

For now, the Baylor researchers have advised that doctors be cautious before vaccinating infants who have recurrent, hard-to-treat infections, which could be a sign of an immune system disorder.

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