ROTAVIRUS VACCINES: Are The Benefits Really Worth the Risk?

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Rotavirus Vaccines: Are the benefits really worth the risk?
By Dr Sherri Tenpenny
Sept. 22, 2016

A study published in the September, 2016 edition of PEDIATRICS reviewed the rates of intussusception before and after the introduction of the Rotavirus vaccines. Researchers found the intussusception hospitalization rate for children aged 8 to 11 weeks was significantly elevated to 16.7–22.9 per 100,000 in all post-vaccine years (except 2011 and 2013), compared with the pre-vaccine baseline rate of 11.7 per 100,000.

The conclusion discovered a significant increase in intussusception when children are given a dose between 8 to 11 weeks (2-3 months). Then researchers went on to say, “Given the magnitude of declines in rotavirus disease compared with this small increase in intussusception, the benefits of rotavirus vaccination outweigh the increased risk of intussusception.”

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What? Wait.

This study is claiming that since the increased rate of intussusception is small, and the decline in the infection rate in the US is large, the “trade-off” is worth the risk?

Let’s break this down. To keep the dates straight, keep in mind the rather obvious association that 8 weeks = 2 months, when the pediatric vaccination visits begin.

As described by the Mayo Clinic:
Intussusception (in-tuh-suh-SEP-shun) is a serious condition in which part of the intestine slides into an adjacent part of the intestine. This “telescoping” creates a bowel obstruction, a true medical emergency. Losing the blood supply to the intestine can lead to death of the tissue, a tear in the bowel wall (perforation), infection in the abdominal cavity (peritonitis) and even death.

The blockage can be diagnosed with an abdominal ultrasound and the treatment is an enema with air or barium. If this is successful, additional treatment is usually not necessary, but an intussusception may recur in up to 10% of children. If the intestine is torn or if the enema is unsuccessful, surgery is mandatory to relieve the obstruction and remove any dead tissue.

A study completed in 2011 evaluated the number of annual deaths from intussusception estimated 2 deaths per 1million live births. With the US live birth rate around 4M per year, that equates to approximately 8 babies per year dying of this condition.

So, up to 230 cases of intussusception per million babies and up to 8 deaths per year could be caused by the vaccinations. Hmm.

Let’s compare that risk to the risk of a rotavirus infection.

Again, as described by the Mayo Clinic:
Rotavirus infection causes diarrhea. According to the CDC, it is the most common cause of diarrhea in infants and children worldwide. Almost all children in the U.S. are likely to have at least one bout of rotavirus infection before their 5th birthday. Once a child gets the virus, it takes about two days to become sick, with vomiting and diarrhea lasting from three to eight days.

A child may develop rotavirus infection more than once because there are many different rotavirus strains, but second infections tend to be less severe. Notably, after a single natural infection, 40% of children are protected against a sub- sequent rotavirus illness.

Although rotavirus infections are unpleasant, infants can almost always be treated at home with extra fluids, such as Pedialye, to prevent dehydration. Occasionally, severe dehydration necessitates IV fluid treatment in the hospital.

The reason rotavirus infections can be deadly in developing countries is the lack of medical care and the inability to adequately rehydrate with oral electrolyte solutions. This is not the case in the U.S. or other developed countries.

What about the individual vaccines?

The rotavirus vaccine is a live oral solution given as part of the routine vaccination schedule. Two vaccines are available. RotaTeq (RV5-Merck) is recommended as a 3-dose series at 2,4, and 6 months. Rotarix (RV1-GlaxoSmithKline) is recommended as a 2-dose series at ages 2 and 4 months. A third rotavirus vaccine, RotaShield, was removed from the market in 1999 due to a large number of intussusception cases attributed to its use.

RotaTeq can shed the live viruses as early as 1 day and as late as 15 days after each dose. With Rotarix, shedding peaks around the 7th day. Transmission of vaccine-strain to unvaccinated contacts (who then contract diarrhea) has been observed with both vaccines. Therefore, rotavirus vaccines should be used with great caution if the vaccinated individual has close contact with persons who are receiving immunosuppressant drugs (ex: prednisone, Remicade, Enbrel, Humira, etc) have an immunodeficiency disease or condition (ex: HIV/AIDS, organ transplant, etc) or have cancer.

So much for vaccinating Child A to protect Child or Adult B.

And the RotaTeq package insert further states, “RotaTeq may not protect all vaccine recipients against rotavirus.”
Doesn’t that mean the risks of the vaccine side effects are assumed but protecting against infection is a flip of the coin?

And the Rotarix insert states, “A relationship between antibody responses to rotavirus vaccination and protection against rotavirus gastroenteritis has not been established.”

Hmm. Aren’t the development of “protective antibodies” the cornerstone of vaccine efficacy?

So, are a few days of inconvenience – a fussy child with greenish, smelly diarrhea – an equal trade off for a vaccine that increases the risk of a medical emergency and even death?

My vote would be to Just Say No.

 


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