Because preterm infants carry an increased risk of having severe complications if they contract rotavirus at a young age, especially while still hospitalized, it would make sense to consider giving the vaccine before they age out of being eligible to receive it. Yet fear of nosocomial complications to other infants in a neonatal intensive care unit (NICU) has precluded administering this vaccine prior to discharge until Hofstetter et al. (10.1542/peds.2017-1110) did a prospective cohort study to see if those fears were well-founded or more of a myth. The authors gave pentavalent rotavirus vaccine when a baby was age-eligible in the NICU. Stool specimens were then analyzed for wildtype and vaccine-type rotavirus strains for all babies in that NICU. The authors were able to vaccinate babies before they became vaccine ineligible more ably than when they were discharged without vaccination after 104 days and found that no vaccine-type rotavirus cases occurred in unvaccinated infants. They conclude that assuming infection control standards are in place when this vaccine is administered to NICU infants, it is worth it to give the vaccine rather than wait until discharge when a preterm infant is no longer eligible and could still develop rotavirus and experience a potentially severe course.
So—is this study enough to convince you to have your preterm infants vaccinated to rotavirus while still in the NICU? To help further convince you, we invited infectious disease specialist Dr. Barbara Pahud and neonatologist Dr. Eugenia Pallotto from Northwestern University to jointly write a commentary (10.1542/peds.2017-3499) that discusses our biases versus evidence for not immunizing while in the NICU and that the time has come to do what Hofstetter et al. did in this newly release study—immunize while in the NICU. Do you need more than 127 infants vaccinated, as were immunized in this study, before you order the vaccine to be given in the NICU or will this study and commentary suffice? We are eager to learn what you do now, and if this study could change your practice and lead to vaccinating in the NICU with the hope that everything will come our fine in the end. Share your thoughts with us by responding to this blog, add a comment with this study on our website, or simply post your thoughts on our Facebook or Twitter pages.
