Rotavirus Vaccine
http://www.usatoday.com/news/health/...otavirus_x.htm
Rotavirus vaccine urged for all babies
By Anita Manning, USA TODAY
A new vaccine to prevent rotavirus, the most common cause of severe diarrhea in children, should be given to all babies, a panel of scientists says. That brings to 15 the number of diseases for which vaccines are recommended.
The Advisory Committee on Immunization Practices, which advises the Centers for Disease Control and Prevention on vaccine policy, voted at its meeting Tuesday in Atlanta to recommend Merck's RotaTeq, a liquid vaccine that will be given in three doses to babies younger than 32 weeks.
Many parents have never heard of rotavirus. But those who have had a child suffer through it say they'll never forget.
"She started vomiting, and she threw up everything she had in her system," says Marty Porter of Cumming, Ga., recalling a very bad week five years ago when her daughter, Jessica, was almost 3. "Every time I tried to give her anything at all, a tiny bit of liquid, she'd start throwing up again. ... When she stopped throwing up, she got diarrhea. I was so scared."
Porter brought her daughter to the emergency room and learned that there was an epidemic of rotavirus infection in her community. "There were so many kids who had it they said they didn't even have any IV poles," she says. They returned home and began several days of trips to the doctor's office and back to the ER. Finally, Jessica was admitted to the hospital for two days.
"I was a wreck," Porter says. "If they didn't have medicines and the IV, I thought Jessica would have died."
Virus as killer
Rotavirus, which can be spread by contact with toys or other surfaces touched by sick children or through contaminated food and water, sends about 250,000 children to emergency rooms each year, says infectious-disease specialist Paul Offit of Children's Hospital of Philadelphia, a co-creator of the vaccine.
What got him interested in this common bug was an experience years ago when he was a resident on call in the emergency department at a Pittsburgh hospital.
"The patient came in in the early-morning hours, around 2 or 3," he says. The boy, 9 months old, had a fever and had been vomiting for several hours. A pediatrician has prescribed frequent sips of fluid, but because of the vomiting, the baby couldn't keep anything down. "By the time he got to us he was severely dehydrated. He had no tears and his veins collapsed."
The doctors were unable to insert an IV line, even after making an incision in the baby's neck, so "we did something I'd never seen before, which was clysis, an administration of fluids into the body by means other than veins," Offit says. Another resident inserted a large-bore needle into the baby's leg bone and tried to infuse fluids into the bone marrow. But the effort failed, and the baby, who had been perfectly healthy a day earlier, died.
Until then, Offit says, he had not thought of rotavirus as a killer. But "this disease can be so rapid in its ability to dehydrate a child that the only way to do anything about it is to prevent it."
By age 2, almost all children have been infected with rotavirus, the CDC says. Subsequent infections are possible but usually much less severe than the first one.
"If you have a child under 3 who comes into the emergency department in winter with fever and vomiting or diarrhea or both, there's a 90% chance it's rotavirus," Offit says. He says 40 to 60 children in the USA die of the disease each year.
In developing countries, where there is limited access to clean water and medical services that can treat the dehydration, rotavirus kills about 600,000 children a year.
The first rotavirus vaccine, RotaShield, developed by Wyeth and licensed in 1998, was pulled from the market a year later because the vaccine, made with a form of monkey virus, caused intussusception, a dangerous bowel obstruction.
The new vaccine, and a second one made by GlaxoSmithKline that is not licensed in the USA, do not include the monkey virus, which scientists believe might have caused the problem. RotaTeq has been tested in more than 70,000 babies in the largest clinical trial ever sponsored by a drug company.
No serious side effects were detected, but the Food and Drug Administration is requiring Merck to do post-licensure studies.
Watch and wait
Despite her daughter's experience, Porter is not sure she'll have her baby, Zach, 3 months old, immunized. "I think vaccines are good, but usually when they come out with a new vaccine, I wait till it's been tested" in real-world use, she says. "I've seen allergic reactions to vaccines, and the things that happened with Vioxx and Bextra (painkillers that were taken off the market because of heart risks) when something new comes out, I just feel cautious."
Pediatricians at the advisory meeting know that they will have to help parents overcome their concerns about the vaccine. "We can't give parents a 100% guarantee," says committee member Janet Gilsdorf, a pediatrician at the University of Michigan Women's Hospital. "But we have a tremendous amount of convincing evidence that this is a safe and effective vaccine."
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I am really on the fence with this one. Owen just got over it, so I am sure we will pass on it. My nephew actually died from dehydration when he had this virus. But even still, I am not sure the benefits outweigh the risks.
Will you be getting this for your baby?
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