A case-control study of risk factors for intussusception among infants in eastern France after the introduction of the rotavirus vaccine

• Published in: Vaccine Vol. 37; no. 32; pp. 4587 - 4593
• Main Authors: Fotso Kamdem, Arnaud, Vidal, Chrystelle, Pazart, Lionel, Leroux, Franck, Pugin, Aurore, Savet, Caroline, Sainte-Claire Deville, Geoffroy, Guillemot, Didier, Massol, Jacques
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 26-07-2019; Elsevier Limited; Elsevier
• Subjects: Abdomen; Age; Babies; Breast feeding; Breastfeeding & lactation; Case studies; Case-control study- rotavirus vaccine; Collaboration; Confidence intervals; Control methods; Family medical history; Gastroenteritis; Immunization; Infants; Intussusception; Life Sciences; Risk analysis; Risk factors; Risk management; Rotavirus; Surgery; Vaccination; Vaccines; Viruses; Vomiting; France; United States > US; CNIL; GUA; OR; Intussusception; CI; CRF; Case-control study- rotavirus vaccine; Infants; IS; WA; Risk factors; GERS
• ISSN: 0264-410X; 1873-2518; 0264-410X
• DOI: 10.1016/j.vaccine.2019.02.053

The objective of the present study was to investigate the risk factors for intussusception (IS) among infants, including vaccination against rotavirus.
Case-control study with systematic inclusion of all infants aged <1 year with suspected IS admitted to emergency departments in the eastern region of France between 1 April 2008 and 31 March 2012. All cases classed level 1 according to the Brighton classification were matched to 4 hospital controls. Two exposure windows were examined; exposure to the first dose of rotavirus vaccine in the 7 and in the 14 days prior to the occurrence of IS.
A total of 115 cases were matched with 457 controls. The average vaccination coverage rate over the 4 years of study was 8.6%. Rotavirus vaccine was not found to be significantly associated with the occurrence of IS in the 7 days (odds ratio (OR) not calculated; p = 0.99) and in the 14 days after administration of one dose vaccine (OR 1.33, 95% confidence interval (CI) 0.14–12.82). Infant formula alone or combined with breastfeeding was associated with an excess risk of IS (OR 2.74, 95% CI 1.10–6.79). A history of gastroenteritis within 2 weeks prior to hospitalisation was also associated with an increased risk (OR 2.24, 95% CI 1.07–4.67).
Our study indicates that infant formula alone or combined with breastfeeding is a risk factor for IS. A small, non-significant increase in the risk of IS was observed after rotavirus vaccination, although the low vaccine coverage rate likely precluded detection of a significant increase in risk.