Trends in intussusception hospitalizations among US infants, 1993-2004: Implications for monitoring the safety of the new rotavirus vaccination program

Jacqueline E. Tate, Lone Simonsen, Cecile Viboud, Claudia Angelica Steiner, Manish M. Patel, Aaron T. Curns, Umesh D. Parashar

Research output: Contribution to journalArticle

Abstract

OBJECTIVES. In 2006, a new rotavirus vaccine was recommended for routine immunization of US infants. Because a previous rotavirus vaccine was withdrawn in 1999 after it was associated with intussusception, monitoring for this adverse event with the new vaccine is important. The objectives of this study were to assess intussusception hospitalizations trends among US infants for 1993 to 2004;provide estimates of hospitalization rates for intussusception for 2002-2004;and assess variations in background rates by age, race/ethnicity, and surgical management. METHODS. By using the Healthcare Cost and Utilization Project's State Inpatient Database that captures US hospital discharges from 16 states representing 49% of the birth cohort during 1993-2004 and from 35 states representing 85% of the birth cohort in 2002-2004, we examined hospitalizations among infants (5 per 100 000) then increased rapidly, peaking at ∼62 per 100 000 at 26 to 29 weeks, before declining gradually to 26 per 100 000 at 52 weeks. Compared with rates among non-Hispanic white infants (27 per 100 000), rates were greater among non-Hispanic black infants (37 per 100 000) and Hispanic infants (45 per 100 000); however, rates did not differ by race/ethnicity for infants who were younger than 16 weeks. CONCLUSIONS. This assessment of US hospitalizations provides up-to-date and nationally representative prevaccine rates of intussusception. Because rates varied almost 12-fold by week of age and to a lesser extent by race/ethnicity during the age of vaccination, adjusting baseline rates to reflect the demographics of the vaccinated population will be crucial for assessing risk for intussusception after rotavirus vaccination.

Original languageEnglish (US)
JournalPediatrics
Volume121
Issue number5
DOIs
StatePublished - May 2008
Externally publishedYes

Fingerprint

Intussusception
Rotavirus
Vaccination
Hospitalization
Safety
Rotavirus Vaccines
Parturition
Hispanic Americans
Health Care Costs
Inpatients
Immunization
Vaccines
Demography
Databases
Population

Keywords

  • Intussusception
  • Rotavirus vaccine
  • Vaccine safety monitoring

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Trends in intussusception hospitalizations among US infants, 1993-2004 : Implications for monitoring the safety of the new rotavirus vaccination program. / Tate, Jacqueline E.; Simonsen, Lone; Viboud, Cecile; Steiner, Claudia Angelica; Patel, Manish M.; Curns, Aaron T.; Parashar, Umesh D.

In: Pediatrics, Vol. 121, No. 5, 05.2008.

Research output: Contribution to journalArticle

Tate, Jacqueline E. ; Simonsen, Lone ; Viboud, Cecile ; Steiner, Claudia Angelica ; Patel, Manish M. ; Curns, Aaron T. ; Parashar, Umesh D. / Trends in intussusception hospitalizations among US infants, 1993-2004 : Implications for monitoring the safety of the new rotavirus vaccination program. In: Pediatrics. 2008 ; Vol. 121, No. 5.
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abstract = "OBJECTIVES. In 2006, a new rotavirus vaccine was recommended for routine immunization of US infants. Because a previous rotavirus vaccine was withdrawn in 1999 after it was associated with intussusception, monitoring for this adverse event with the new vaccine is important. The objectives of this study were to assess intussusception hospitalizations trends among US infants for 1993 to 2004;provide estimates of hospitalization rates for intussusception for 2002-2004;and assess variations in background rates by age, race/ethnicity, and surgical management. METHODS. By using the Healthcare Cost and Utilization Project's State Inpatient Database that captures US hospital discharges from 16 states representing 49{\%} of the birth cohort during 1993-2004 and from 35 states representing 85{\%} of the birth cohort in 2002-2004, we examined hospitalizations among infants (5 per 100 000) then increased rapidly, peaking at ∼62 per 100 000 at 26 to 29 weeks, before declining gradually to 26 per 100 000 at 52 weeks. Compared with rates among non-Hispanic white infants (27 per 100 000), rates were greater among non-Hispanic black infants (37 per 100 000) and Hispanic infants (45 per 100 000); however, rates did not differ by race/ethnicity for infants who were younger than 16 weeks. CONCLUSIONS. This assessment of US hospitalizations provides up-to-date and nationally representative prevaccine rates of intussusception. Because rates varied almost 12-fold by week of age and to a lesser extent by race/ethnicity during the age of vaccination, adjusting baseline rates to reflect the demographics of the vaccinated population will be crucial for assessing risk for intussusception after rotavirus vaccination.",
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AU - Steiner, Claudia Angelica

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AB - OBJECTIVES. In 2006, a new rotavirus vaccine was recommended for routine immunization of US infants. Because a previous rotavirus vaccine was withdrawn in 1999 after it was associated with intussusception, monitoring for this adverse event with the new vaccine is important. The objectives of this study were to assess intussusception hospitalizations trends among US infants for 1993 to 2004;provide estimates of hospitalization rates for intussusception for 2002-2004;and assess variations in background rates by age, race/ethnicity, and surgical management. METHODS. By using the Healthcare Cost and Utilization Project's State Inpatient Database that captures US hospital discharges from 16 states representing 49% of the birth cohort during 1993-2004 and from 35 states representing 85% of the birth cohort in 2002-2004, we examined hospitalizations among infants (5 per 100 000) then increased rapidly, peaking at ∼62 per 100 000 at 26 to 29 weeks, before declining gradually to 26 per 100 000 at 52 weeks. Compared with rates among non-Hispanic white infants (27 per 100 000), rates were greater among non-Hispanic black infants (37 per 100 000) and Hispanic infants (45 per 100 000); however, rates did not differ by race/ethnicity for infants who were younger than 16 weeks. CONCLUSIONS. This assessment of US hospitalizations provides up-to-date and nationally representative prevaccine rates of intussusception. Because rates varied almost 12-fold by week of age and to a lesser extent by race/ethnicity during the age of vaccination, adjusting baseline rates to reflect the demographics of the vaccinated population will be crucial for assessing risk for intussusception after rotavirus vaccination.

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