Gastroenteritis in Infants : The Now Recommended Vaccination

Posted on Feb 18 2014 - 5:27am by Admin

After two negative reviews in 2006 and 2010, the High Council of Public Health (HCSP) now recommends vaccination of infants against rotavirus gastroenteritis. This change of opinion is based on evidence of effectiveness of the vaccine, but is subject to a price reduction of two vaccines available on the market.

 

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HCSP recommends vaccination against gastroenteritis subject to a reduction in the price of the two vaccines available .

Rotavirus gastroenteritis is a common illness in young children, especially infants. In France , she is responsible for 14,000 hospitalizations per year in less than 3 years and 7 to 17 deaths . This disease is contracted in hospital of infants hospitalized for respiratory infection.

Two vaccines are available but not recommended until

Two vaccines are available for ten years in France , Rotarix ® ( monovalent vaccine administered in two doses , 2 and 3 months) and RotaTeq ® ( pentavalent vaccine in three doses administered at 2, 3 and 4 months). So far, the HCSP had an unfavorable opinion of vaccination against rotavirus in 2006 and 2010. This opinion was based on the presence in these vaccines swine virus and the existence of ” a small increased risk of intussusception ” after the administration of these vaccines.

As a result, few vaccines were administered in France far because of this “no recommendation ” but the high cost of vaccines available (180 € for 2 doses of Rotarix ® and € 230 for 3 doses of RotaTeq ® ) .
Efficiency revised upwards , with an acceptable risk

The change of mind HCSP is justified by the results of a study in 2013 revaluing the vaccination against rotavirus. This study showed indeed a positive impact of vaccination in industrialized countries . Basically, the vaccine before the age of 6 months can reduce by 80% the rate of hospitalization of children for rotavirus diarrhea . In addition, the administration of this vaccine in a large population of infants confers herd immunity effect , that is to say that even unvaccinated infants are protected but only if vaccination coverage in this population remains high.

As for safety , it has been shown that pig virus contained in both vaccines have no adverse effects and the risk of intussusception few days after vaccination but are still very low, in the range 1 to 6 cases per 100 000 children vaccinated .

But a recommendation subject to lower prices for vaccines

HCSP now recommends vaccination in infants aged less than 6 months and stresses the importance of respecting the schedule of administration of each vaccine (single or pentavalent ) .Administered orally , these vaccines can be administered simultaneously with other vaccines in the infant immunization schedule .

However, the HCSP states that ” this strategy should be implemented only if the price of vaccines lead to cost / effectiveness ratios acceptable .” In other words, this recommendation is made subject to a price reduction of two existing vaccines on the market .This recommendation is conditional and will not have direct impact on the immunization schedule. Before price negotiations are successful, the level of medical service of these vaccines should be assessed by the High Health Authority before undertake discussions with the Health Insurance for its supported by Social Security. This is the Economic Committee for Health Products (CEPS ), which then intervene to negotiate prices with manufacturers .

 

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