642. Rotavirus Vaccination in Neonatal Intensive Care Units (NICUs): Safety and Feasibility
Session: Oral Abstract Session: Vaccines for all Ages
Friday, October 4, 2013: 9:30 AM
Room: The Moscone Center: 200-212
Background:

Rotavirus (RV) is the most common vaccine-preventable cause of gastroenteritis (GE) in children. Currently, RV vaccination of infants in the NICU is not recommended due to the theoretical risk of transmission within the unit. Infants in the NICU are however at very high risk of complications related to RVGE and most will exceed age-eligibility for the first vaccine dose while admitted. RV vaccination was implemented in 2011 in two NICUs in response to this problem. The objective of this study is to describe the safety, feasibility, and impact of a NICU-based vaccination program against RV. 

Methods:

Hospitalized infants in two NICUs (The Montreal Children’s Hospital [MCH] and the Royal Victoria Hospital [RVH]) who received ≥1 dose of the RV5 vaccine were included. Healthcare-associated (HA) RV cases since 2009 have been identified through prospective surveillance and reviewed. Charts of infants vaccinated and charts of infants with HA RVGE in the NICU will be reviewed. Data on demographics, underlying conditions, GE, other risk factors, vaccination history, and clinical presentation will be collected

Results:

From July 2011 to March 2013, 103 infants received ≥1 dose of the RV5 vaccine, for a total of 153 vaccine doses. On average, 7 RV doses were administered per month. Sixty-two infants (60%) were male and the vaccinated population had a median gestational age of 29 4/7 weeks (IQR: 27 – 33 1/7) and a median birth weight of 1220 grams (IQR: 860 – 1890). Median chronological age at first dose was 60 days (IQR: 59 – 66), with a second dose occurring between 23 to 77 days later (Median: 36.5; IQR: 33 – 54). The median overall length of stay in the NICU was 82 days (IQR: 57-115). Since July 2011, 14.2% (153/ 1076) of NICU admissions were vaccinated against RV. Seven cases of HA-RVGE occurred prior to program implementation whereas none has been reported since vaccination began. 

Conclusion:

There has been no HA-RVGE case since the start of RV vaccination in our NICUs. This study provides evidence for the safety of a RV vaccination program in NICUs that will aim to protect patients with the highest risk of RVGE complications once discharged.

Samuel Thrall, MDCM (c)1, Milagros Gonzales, MSc1, Philippe Lamer, NNP MSc2, Gabrielle Girard, B. Pharm MSc3, Thérèse Perreault, MD2 and Caroline Quach, MD MSc1,4,5, (1)Division of Infectious Diseases; Department of Pediatrics, The Montreal Children's Hospital, Montreal, QC, Canada, (2)Division of Neonatology; Department of Pediatrics, The Montreal Children's Hospital, Montreal, QC, Canada, (3)Department of Pharmacy, The Montreal Children's Hospital, Montreal, QC, Canada, (4)Epidemiology, Biostatistics, and Occupational Health, Mc Gill University, Montreal, QC, Canada, (5)Vaccine Study Centre, Research Institute of the Mcgill Univ. Health Centre, Montreal, QC, Canada

Disclosures:

S. Thrall, None

M. Gonzales, None

P. Lamer, None

G. Girard, None

T. Perreault, None

C. Quach, Merck: Grant Investigator, Research grant
GlaxoSmithKline: Grant Investigator, Research grant

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