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Gut problem no obstruction to vaccination

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Doctors have been told to continue vaccinating children against rotavirus, a severe form of gastroenteritis in babies and young children, despite evidence it increases the risk of a rare form of bowel obstruction.

An investigation commissioned by the Therapeutic Goods Administration has found that the vaccines Rotarix and RotaTeq are associated with instances of intussusception – a rare blockage caused when one segment of the bowel telescopes into another.

Using data gathered from six states and territories over a three-year period, the investigators identified 260 cases of intussusception following vaccination against the rotavirus.

The risk was found to be greatest following the initial dose with the vaccine.

But the study found that the overall incidence of intussusception associated with the rotavirus vaccines was small.

“The risk of intussusception following rotavirus vaccination is estimated as approximately six additional cases among every 100,000 infants vaccinated, or 14 additional cases per year in Australia,” the TGA said.

The regulator said that the risk of a minor increase in the incidence of intussusception was worth taking in light of the much larger benefits provided by vaccination against the rotavirus.

 “Prior to the introduction of the rotavirus vaccine, there were an estimated 10,000 hospitalisations annually in Australian children under five years due to rotavirus gastroenteritis,” the TGA said. “Since the introduction of Rotarix and RotaTeq onto the National Immunisation Program, emergency department visits for acute gastroenteritis in young children have declined and hospitalisations for rotavirus gastroenteritis in the under five-year age group have reduced by over 70 per cent.”

Health authorities have recommended that children continue to be inoculated against rotavirus despite evidence the vaccines increase the risk of a rare form of bowel obstruction.

“Based on the established benefits of rotavirus vaccination and the rare occurrence of intussusception, the condition remains rare and this risk is outweighed by the benefits of rotavirus vaccination in preventing rotavirus infections,” the regulator said.

Following the investigating, the manufacturers of the vaccines have included extra safety information advising of the risk of intussusception associated with their products.

In addition, the TGA has said doctors should advise parents and carers of the risks and signs of intussusception, and the importance of seeking early medical attention if they suspect it has occurred.

Adrian Rollins