ANDRÉ PICARD
From Tuesday's Globe and Mail Published on Tuesday, Jan. 22, 2008 11:33AM EST Last updated on Monday, Mar. 30, 2009 2:47PM EDT
A blue-ribbon panel of scientists is urging parents to have their babies vaccinated against rotavirus, a common cause of diarrhea and vomiting in youngsters, and a disease that often wreaks havoc in daycare centres.
"Parents should consider doing this because their infants and families are likely to benefit," Joanne Langley, chairwoman of the National Advisory Committee on Immunization, said in an interview. "This is a safe and effective vaccine."
Dr. Langley, a pediatric infectious disease specialist at IWK Health Centre in Halifax, said the committee stopped short of calling for a government-funded universal vaccine program because it has not yet completed cost-effectiveness studies. In the meantime, parents or private insurance companies will have to pay the cost.
The list price for the vaccine is $165 in total for the three required doses. The good news for parents is that the new vaccine, sold under the brand name RotaTeq, does not require a needle; it is given orally, squirted into the baby's mouth.
Rotavirus is a family of viruses that causes gastroenteritis, a common childhood disease that infects virtually all children by the age of 5. But the illness can be severe, even fatal, in babies.
"The little guys can get really, really sick with rotavirus," said Anna Karwowska, a pediatric emergency physician at the Children's Hospital of Eastern Ontario in Ottawa. It is characterized by the combination of diarrhea, vomiting and high fever.
"They get dehydrated really fast and that's dangerous," she said.
Dr. Karwowska said she hopes parents will heed the advice to vaccinate because it could save them a lot of grief, including visits to the ER and time off work.
She said rotavirus is a "huge burden" on emergency rooms, particularly during the peak months of April and May.
According to NACI, if all babies were vaccinated, about 56,000 cases of rotavirus gastroenteritis would be prevented annually, as would 33,000 physician visits, 15,000 emergency department visits and up to 5,000 hospitalizations.
In Canada, deaths from rotaviruses are rare. But in the developing world, rotaviruses are among the leading causes of childhood death, killing an estimated 600,000 children each year.
RotaTeq, a product of Merck Frosst Canada Ltd., was approved in August, 2006. But pediatricians tend to await a NACI recommendation before embracing a new vaccine. It is administered in three doses between the ages of six weeks and 32 weeks. The first dose must be given before 12 weeks of age and the vaccine is not recommended for older children.
A second rotavirus vaccine, Rotarix from GlaxoSmithKline Inc., was approved in October, 2007, but has not yet been subjected to a NACI review.
A rotavirus vaccine was first developed in the late 1990s, but was pulled from the U.S. market in 1999 after it was linked to an increase in intussusception, a rare, life-threatening blockage of the intestine. That vaccine never made it to the Canadian market.
As a result of this troublesome history, the new rotavirus vaccines are among the most thoroughly tested and closely monitored.
RotaTeq was tested on 68,000 children between the ages of six weeks and 12 weeks in the United States, Europe, Central America and Taiwan. It prevented 98 per cent of severe gastroenteritis caused by rotaviruses and cut hospitalizations by 63 per cent. Rotarix was studied among 63,000 babies six weeks and older in 11 Latin American countries and Finland. It prevented 85 per cent of cases of severe gastroenteritis and reduced hospitalizations by 42 per cent.
In other words, the two competing drugs had similar outcomes: preventing the vast majority of serious illness from rotaviruses with few serious side effects. In particular, there was no apparent risk of intussusception.
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