2280. Antibiotic Exposure Does Not Impact Serological Responses to Rotavirus Vaccination
Session: Poster Abstract Session: Miscellaneous Vaccines
Saturday, October 6, 2018
Room: S Poster Hall
  • Rotavirus Immunization and Antibiotic Exposure 27SEP2018.pdf (1.0 MB)
  • Background:

    Antibiotic exposure around the time of rotavirus (RV) immunization has been suggested to diminish immune responses, but data are sparse.


    We retrospectively analyzed data from a randomized RV vaccine study (NCT01266850) outlined in the Table. Concomitant antibiotic use, defined as receipt of an antibiotic 14 days before or 7 days after RV immunization, was recorded. The primary outcome was RV-specific IgA seroresponse (IgA ≥20 U/mL) by ELISA obtained 1 month after the last dose of RV vaccine  and geometric mean titer (GMT) to strain WC3 (RV5 backbone) or strain 89-12 (RV1 backbone). Only subjects who received all scheduled vaccine doses and phlebotomy were included.  Data were assessed for homogeneity across vaccine schedule groups, stratified by antibiotic exposure.  We examined differences in seroresponse adjusting for treatment group, gender, race, ethnicity, and study site using logistic regression models.


    Of the 1384 immunized children, 1174 (85%) met inclusion criteria. 

    Table: Treatment Allocation and Effect of Antibiotic Exposure on Seroresponses







    Immunization Schedule

    Rotateq® (RV5) 3 doses


    RV5, RV1, RV1


    RV5, RV5, RV1


    Rotarix® (RV1) 2 doses


    RV1, RV5, RV5


    Seroresponse: Antibiotic Exposed

    21/25 (84%)

    20/20 (100%)

    18/22 (82%)

    13/15 (87%)

    32/32 (100%)

    Seroresponse: Antibiotic Not-Exposed

    167/181 (92%)

    168/187 (90%)

    158/172 (92%)

    209/272 (77%)

    238/248 (96%)

    Nearly 10% (n=114) of participants were antibiotic exposed; group 4 had the least antibiotic exposure (p=0.05). No differences in GMT or seroresponses were observed to either WC3 or 89-12 (Figure) by antibiotic exposure. In the multivariable logistic regression model, there were no significant differences for gender, race, ethnicity, site, or antibiotic exposure (p-value ≥0.5 for IgA seroresponse). The only observed difference in seroresponses was by RV vaccine group (p<0.0001).


    Antibiotic administration around the time of RV vaccine did not diminish RV-specific IgA seroresponses observed 1 month after the last RV vaccine dose.   

    Figure – Proportion Mounting IgA Seroresponse to Rotavirus Immunization, Stratified by Antibiotic Exposure Status



    Evan J. Anderson, MD1, Benjamin Lopman, PhD2, Jumi Yi, MD3, Inci Yildirim, MD PhD MSc4,5, C. Buddy Creech, MD, MPH, FPIDS6,7, Jill El-Khorazaty, MS8, Andi L. Shane, MD, MPH, MSc, FIDSA, FPIDS3,9 and Kathryn Edwards, MD, FIDSA10, (1)Departments of Medicine and Pediatrics, Divisions of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, (2)Emory University, Atlanta, GA, (3)Pediatrics, Emory University School of Medicine, Atlanta, GA, (4)Pediatric Infectious Diseases, Emory University School of Medicine, Atlanta, GA, (5)Rollins School of Public Health, Emory University, Atlanta, GA, (6)Pediatric Infectious Diseases, Vanderbilt University Medical Center, Nashville, TN, (7)Vanderbilt Vaccine Research Program, Vanderbilt University School of Medicine, Nashville, TN, (8)The Emmes Corporation, Rockville, MD, (9)Emory University Rollins School of Public Health, Atlanta, GA, (10)Department of Pediatrics, Division of Pediatric Infectious Diseases, Vanderbilt University School of Medicine, Nashville, TN


    E. J. Anderson, NovaVax: Grant Investigator , Research grant . Pfizer: Grant Investigator , Research grant . AbbVie: Consultant , Consulting fee . MedImmune: Investigator , Research support . PaxVax: Investigator , Research support . Micron: Investigator , Research support .

    B. Lopman, None

    J. Yi, None

    I. Yildirim, None

    C. B. Creech, Pfizer: Grant Investigator , Research grant . Novartis: Grant Investigator , Research grant .

    J. El-Khorazaty, None

    A. L. Shane, International Scientific Association of Probiotics and Prebiotics: Member , Reimbursement of travel and lodging for attendance and presentations at international scientific meetings 2016 and prior and support for attendance at meeting at FDA in 2017 to discuss probiotic and prebiotic research .

    K. Edwards, Novartis: Grant Investigator , Research grant . Novartis: Scientific Advisor , Consulting fee .

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.