Busy practice nurses believe that, if rotavirus vaccination was recommended for inclusion
in the childhood immunisation programme, they could save time by administering the pentavalent oral rotavirus vaccine
RotaTeq®* at the same time as an injectable vaccine that is already given routinely.
According to a survey presented at the Health Protection 2010 conference in Warwick1, practice nurses anticipate that
administration of the oral rotavirus vaccine would take the same length of time as the injectable DTaP/IPV/Hib vaccine (10
minutes).
However, if the two vaccines were administered at the same visit, the estimated consultation and administration time for the
rotavirus vaccine is 4 minutes 26 seconds. In other words co-administration would take less than 15 minutes rather than two
visits of ten minutes each.
Attitudes to the oral rotavirus vaccine and its administration were the same whether or not the practice nurse had experience of
administering oral vaccines.
The survey, carried out by ICM Research, was conducted via computer-assisted telephone interviews with practice nurses from
across the UK who routinely administer infant vaccinations (children aged one to 12 months). To keep the sample balanced,
20% of those interviewed had no experience of administering an oral vaccination.
Interviews were split between 200 nurses who saw an online video demonstration of the oral rotavirus vaccine being
administered and 300 who did not.
"The economic impact of introducing the oral rotavirus vaccine into the childhood vaccination programme is important. The
potential impact on Practice Nurses' time is small and the benefit of preventing rotavirus disease is great. The oral rotavirus
vaccine can be easily added to the appointment time during which we administer the injectable vaccines to our infants," says
George Kassianos, GP Bracknell and RCGP Immunisation Lead.
The onset of rotavirus gastroenteritis can be rapid and unpredictable. As rotavirus disease is seasonal, with most cases
occurring between January and April, reducing rotavirus cases would also free up valuable NHS resources at a time when they
are often stretched.2
The survey was conducted by independent market research company ICM Research and funded by Sanofi Pasteur MSD
manufacturer of the pentavalent oral rotavirus vaccine RotaTeq®.
* Rotavirus vaccine, live, oral
Notes
More about rotavirus gastroenteritis
By the age of five, almost every child will experience an episode of rotavirus gastroenteritis. While it is estimated that annually 3.6 million
children experience an episode of rotavirus, 87,000 are hospitalised and over 700,000 require a doctor's visit; with a cumulative risk of
hospitalisation and doctor's visits of one in 54 and one in seven respectively.3 Among European children aged 5 or younger, about 200 to
250 die every year from rotavirus disease.4
As rotavirus is highly contagious and relatively resistant to its environment,5,6 vaccination is recognised as the only effective control measure
to have a significant impact on the burden of severe paediatric rotavirus gastroenteritis.7,8
The typical symptoms of rotavirus infection are watery diarrhoea, vomiting, fever and abdominal pain. The severity ranges from
asymptomatic forms (most of the cases) to severe forms with a dramatic loss of body fluid (dehydration) that can be fatal.7, 9
Re-hydration is the key treatment and should be applied as soon as possible. There are no risk factors for developing a severe case of
rotavirus gastroenteritis. Overnight, seemingly mild form of the disease can become life-threatening9 and require hospitalisation for
intravenous re-hydration. Different rotavirus types can circulate concomitantly and in proportions that may vary from country to country and
from one season to another. Thus, it is hard to predict which rotavirus type will infect a child.10 Unlike for many other childhood infectious
diseases, several infections with rotavirus are needed to build protection against rotavirus disease. Successive infections usually occur with
different rotavirus types. A protection of 92% required three successive rotavirus infections according to a study.11 Nearly 90% of rotavirus
gastroenteritis cases occur between three months and three years of age.2
More about RotaTeq®
RotaTeq® (Rotavirus vaccine, live, oral) is an orally administered, fully liquid and ready-to-use vaccine given in 3 doses. In its clinical
development RotaTeq has demonstrated a consistent level of efficacy not only across different trials; 98% to 100% against severe paediatric
rotavirus gastroenteritis, but also across regions; Latin America, US and Europe, and populations; term, premature and breastfed infants.12,
13, 14, 15 Protection provided by RotaTeq covers the main risk period of RVGE that extends from 3 months to 3 years of age, with a high level
of efficacy starting 14 days after the first dose and up to 3 years after the third dose.2, 10, 16, 17
As of March 2010, RotaTeq® has been licensed in 95 countries and launched in 56 around the world18 including the member states of the
European Union, and more than 18 million doses have been distributed worldwide. In Western Europe, rotavirus vaccination is now part of
the national immunisation program in Austria, Belgium, Finland and Luxembourg.
References
1. Stuart C et al. Evaluation of Consultation Time for Paediatric Vaccines, poster presented at Health Protection 2010, September 2010 healthprotectionconference
2. Van Damme et al.Multicenter prospective study of the burden of rotavirus acute gastro-enteritis in Europe, 2004-2005: the REVEAL study. JID 2007: 195 (suppl 1) S4-S16.
3. Soriano-Gabarro M. et al. Burden of rotavirus disease in European countries. Pediatr Infect Dis J 2006:25 (1):S7-S11.
4. Parashar UD, Glass RI. Rotavirus vaccination in Europe: the time has finally arrived. J Pediatr Gastroenterol Nutr 2008;46:21-23.
5. Fischer TK, Bresee JS, Glass RI. Rotavirus vaccines and the prevention of hospital acquired diarrhea in children. Vaccine 2004;22:49-54.
6. Dennehy PH. Transmission of rotavirus and other enteric pathogens in the home. Pediatr infect Dis J 2000; 19[Suppl10]: S103-5.
7. Clark HF and Offit PA. Vaccines for rotavirus gastroenteritis universally needed for infants. Ped Ann 2004; 33(8). 537-543.
8. Parashar UD. et al. Global illness and deaths caused by rotavirus disease in children. Emerg Inf Dis 2003;9:565-572.
9. Matson D.O. In: Long SS Ed. Principles and Practice of Paediatric Infectious Diseases. New York: Churchill Livingstone 2003. 1105-1108.
10. Van Damme et al.Distribution of rotavirus genotypes in Europe, 2004-2005: the REVEAL study. JID 2007:195(suppl 1) S17-S25.
11. VelГЎzquez FR et al.Rotavirus infections in infants as protection against subsequent infections. N Engl J Med 1996; 335:1022-1028.
12. Block SL et al.. Efficacy, immunogenicity, and safety of a pentavalent human-bovine (WC3) reassortant rotavirus vaccine at the end of shelf life. Pediatrics 2007;119:11-18.
13. Vesikari T et al.Safety and Efficacy of a Pentavalent HumanпїЅпїЅ"Bovine (WC3) Reassortant Rotavirus Vaccine. N Engl J Med 2006; 354(1):23-33.
14. Goveia M.G et al. Safety and efficacy of the pentavalent human-bovine (wc3) reassortant rotavirus vaccine in healthy premature infants. Pediatr Infect Dis J 2007; 26:1099-1104.
15. Goveia and al. Efficacy of pentavalent Human-Bovine (WC3) reassortant rotavirus vaccine based on breastfeeding frequency. Pediatr Infect Dis J 2008, 27(7):656-658.
16. Vesikari T. et al.. Sustained efficacy of the pentavalent rotavirus vaccine, RV5, up to 3.1 years following the last dose of vaccine Pediatr Infect Dis J. 2010;29(10): 1-7.
17. Dennehy P et al. Efficacy of the Pentavalent Rotavirus Vaccine, RotaTeq®, between Doses: Potential Benefits of Early Protection. PAS and ASPR Joint Meeting. Honolulu HawaГЇ USA, May 2008
(abstract and oral presentation).
18. Merck internal data, March 2010.
Source:
Sanofi Pasteur MSD
View drug information on Rotateq.
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