Infants should be screened for severe combined immunodeficiency prior to receiving the rotavirus vaccine, according to a study published in the New England Journal of Medicine. The study details three cases where such children actually developed rotaviral infection after vaccination.
Children with severe combined immunodeficiency lack protection provided by key components of the immune system – the T- and B-cells. As a result, these children have no protection against many infections that can become life-threatening. It is recommended that such children not receive vaccines containing live virus. But they usually are not diagnosed before the rotavirus vaccine – a live virus vaccine – is administered. Rotavirus vaccine is given three doses between 6 and 32 weeks of age. The American College of Medical Genetics recently recommended that severe combined immunodeficiency be included as a part of the newborn screen.
In three cases detailed by the researchers at Baylor University, all of the infants received rotavirus vaccination before they were diagnosed with severe combined immunodeficiency. Analysis of the viral genetic material in stool specimens from the infants revealed that the virus they contracted originated with the vaccine. None of the children were able to fight off the rotavirus until they underwent bone marrow transplantation or enzyme replacement therapy that gave them a functioning immune system.
The Baylor researchers advised that doctors be cautious before vaccinating infants who have recurrent, hard-to-treat infections, which could be a sign of an immune system disorder.
Rotavirus is one of the most common causes of diarrhea, and the leading cause of severe, dehydrating diarrhea in infants and young children. Such infections cause approximately 3 million cases of diarrhea and 55,000 hospitalizations for diarrhea and dehydration in children under 5 years old each year in the United States. Rotavirus causes more than half a million deaths worldwide every year, mostly in developing countries where nutrition and healthcare are not optimal.