Downloaded from http://fn.bmj.com/ on June 6, 2015 - Published by group.bmj.com
PostScript
▸ http://dx.doi.org/10.1136/archdischild-2014-306067 Arch Dis Child Fetal Neonatal Ed 2014;99:F251–F252. doi:10.1136/archdischild-2014-306107
REFERENCES 1
2
3
4
5
6
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Kilgore PE, Holman RC, Clarke MJ, et al. Trends of diarrheal disease, associated mortality in US children, 1968 through 1991. JAMA 1995;274:1143–8. Buttery JP, Lambert SB, Grimwood K, et al. Reduction in rotavirus-associated acute gastroenteritis following introduction of rotavirus vaccine into Australia’s national childhood vaccine schedule. Pediatr Infect Dis J 2011;30:S25–9. GSK. Rotarix product information, 2013. http://www. gsk.com.au/resources.ashx/vaccineproductschilddata proinfo/447/FileName/1FABE834C79014A0B6A83A B8CD065ECB/Rotarix_Liquid_PI_011_Approved.pdf. Carlin JB, Macartney K, Lee KJ, et al. Intussusception risk and disease prevention associated with rotavirus vaccines in Australia’s national immunisation program. Clin Infect Dis 2013;57:1427–34. Stumpf KA, Thompson T, Sanchez PJ. Rotavirus vaccination of very low birth weight infants at discharge from the NICU. Pediatrics 2013;132: e662–5. Werther RL, Crawford NW, Boniface K, et al. Rotavirus vaccine induced diarrhea in a child with severe combined immune deficiency. J Allergy Clin Immunol 2009;124:600. Fang AYW, Tingay DG. Early observations in the use of oral rotavirus vaccination in infants with functional short gut syndrome. J Paediatr Child Health 2012;48:512–16.
Slow uptake of rotavirus vaccination in UK neonatal units In July 2013 rotavirus vaccination was included in the childhood immunisation schedule. Rotavirus infection is responsible for over half of all gastroenteritis infections in children under 5 years of age1 and it constitutes a significant health and economic burden.2 3 Guidance from Public Health England is clear that premature infants should receive their immunisations according to their chronological age. Therefore an important number of rotavirus vaccinations will be given on neonatal units. There appears to be apprehension about giving a live attenuated rotavirus vaccination on the neonatal unit, both with the risks of potential transmission to vulnerable infants and the uncertain
F252
effects of giving the vaccine to certain high risk infants within a neonatal setting. Six months following the introduction of the rotavirus vaccine, we conducted a telephone survey of tertiary neonatal units across the UK to evaluate whether rotavirus vaccination has become standard practice in each unit. Our response rate was 92% (56 out of 61 units completed survey). Twenty per cent of units (11/56) did not administer the vaccine. Of those units giving rotavirus vaccine there was considerable variation in practice with only 63% of such units (29/45) following the Joint Committee on Vaccination and Immunisation (JCVI) guidance to target all babies. Thirteen units gave rotavirus vaccine to selected infants based on a consultant decision made on individual cases and three units had specific exclusions related to surgical infants or neutropenia. Only 37% of units (17/45) had a written guideline for giving rotavirus vaccine in their unit. As well as variation in infants offered vaccination, we identified considerable variation in infection control precautions following vaccination. Following rotavirus vaccination, the JCVI state there is a potential for transmission through faecal material for up to 14 days.1 From our survey 20% of units (10/45) are not using any infection precautions following administration, 17% of units (8/45) use gloves and aprons for up to 1 week and 11% (5/45) use precautions for 48 h following administration of the vaccine. There is no national recommendation about infection precautions following rotavirus vaccination. It is clear that a large number of neonatal units are not following national guidance with regards to vaccination with many neonatal units yet to introduce rotavirus vaccination. It is important to explore the underlying reasons for this to ensure optimal uptake. Further data are necessary to determine how the vaccine is tolerated in vulnerable preterm infants, and also to inform infection control practices around administering live vaccines in high-risk clinical areas.
Contributors DD and NK developed the concept for the survey; SJ and BB developed and conducted the telephone survey and all contributed to writing the letter. Competing interests None. Provenance and peer review Not commissioned; internally peer reviewed. To cite Jaques S, Bhojnagarwala B, Kennea N, et al. Arch Dis Child Fetal Neonatal Ed 2014;99:F252. Accepted 7 February 2014 Published Online First 4 March 2014
▸ http://dx.doi.org/10.1136/archdischild-2014-306107 Arch Dis Child Fetal Neonatal Ed 2014;99:F252. doi:10.1136/archdischild-2014-306067
REFERENCES 1
2
3
Infant rotavirus vaccination programme – questions and answers for healthcare practitioners. Public Health England, 2013. Soriano-Gabarró M, Mrukowicz J, Vesikari T, et al. Burden of rotavirus disease in European Union countries. Pediatr Infect Dis J 2006;25(1 Suppl):S7–11. Giaquinto C, Van Damme P, Huet F, et al. Cost of community acquired pediatric rotavirus gastroenteritis in 7 European countires: the reveal study. J Infect Dis 2007;195(Suppl 1):S36–44.
Retraction notice Fazilleau L, Parienti JJ, Bellot A, Guillois B. NIDCAP in preterm infants and the neurodevelopmental effect in the first 2 years. Arch Dis Child Fetal Neonatal Ed Published Online First: 31 October 2013 doi:10.1136/archdischild-2012-303508.
This paper has been retracted because it contained errors in the data extraction and analyses that affect the results, figures and tables. Data from a study that had been published in two different journal articles were included twice in the analyses. There was an error in the description of the measures used for neurodevelopmental testing in the reporting of the results.
Siobhan Jaques, Bikash Bhojnagarwala, Nigel Kennea, Donovan Duffy Neonatal Unit, St. George’s Hospital, London, UK Correspondence to Dr Siobhan Jaques Neonatal Unit, St. George’s Hospital, London SW17 0QT, UK; [email protected]
Arch Dis Child 2014;99:F252. doi:10.1136/archdischild-2012-303508ret
Arch Dis Child May 2014 Vol 99 No 3
Downloaded from http://fn.bmj.com/ on June 6, 2015 - Published by group.bmj.com
Retraction notice
Arch Dis Child Fetal Neonatal Ed 2014 99: F252
doi: 10.1136/archdischild-2012-303508ret Updated information and services can be found at: http://fn.bmj.com/content/99/3/F252.1
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Notes
To request permissions go to: http://group.bmj.com/group/rights-licensing/permissions To order reprints go to: http://journals.bmj.com/cgi/reprintform To subscribe to BMJ go to: http://group.bmj.com/subscribe/
PostScript
▸ http://dx.doi.org/10.1136/archdischild-2014-306067 Arch Dis Child Fetal Neonatal Ed 2014;99:F251–F252. doi:10.1136/archdischild-2014-306107
REFERENCES 1
2
3
4
5
6
7
Kilgore PE, Holman RC, Clarke MJ, et al. Trends of diarrheal disease, associated mortality in US children, 1968 through 1991. JAMA 1995;274:1143–8. Buttery JP, Lambert SB, Grimwood K, et al. Reduction in rotavirus-associated acute gastroenteritis following introduction of rotavirus vaccine into Australia’s national childhood vaccine schedule. Pediatr Infect Dis J 2011;30:S25–9. GSK. Rotarix product information, 2013. http://www. gsk.com.au/resources.ashx/vaccineproductschilddata proinfo/447/FileName/1FABE834C79014A0B6A83A B8CD065ECB/Rotarix_Liquid_PI_011_Approved.pdf. Carlin JB, Macartney K, Lee KJ, et al. Intussusception risk and disease prevention associated with rotavirus vaccines in Australia’s national immunisation program. Clin Infect Dis 2013;57:1427–34. Stumpf KA, Thompson T, Sanchez PJ. Rotavirus vaccination of very low birth weight infants at discharge from the NICU. Pediatrics 2013;132: e662–5. Werther RL, Crawford NW, Boniface K, et al. Rotavirus vaccine induced diarrhea in a child with severe combined immune deficiency. J Allergy Clin Immunol 2009;124:600. Fang AYW, Tingay DG. Early observations in the use of oral rotavirus vaccination in infants with functional short gut syndrome. J Paediatr Child Health 2012;48:512–16.
Slow uptake of rotavirus vaccination in UK neonatal units In July 2013 rotavirus vaccination was included in the childhood immunisation schedule. Rotavirus infection is responsible for over half of all gastroenteritis infections in children under 5 years of age1 and it constitutes a significant health and economic burden.2 3 Guidance from Public Health England is clear that premature infants should receive their immunisations according to their chronological age. Therefore an important number of rotavirus vaccinations will be given on neonatal units. There appears to be apprehension about giving a live attenuated rotavirus vaccination on the neonatal unit, both with the risks of potential transmission to vulnerable infants and the uncertain
F252
effects of giving the vaccine to certain high risk infants within a neonatal setting. Six months following the introduction of the rotavirus vaccine, we conducted a telephone survey of tertiary neonatal units across the UK to evaluate whether rotavirus vaccination has become standard practice in each unit. Our response rate was 92% (56 out of 61 units completed survey). Twenty per cent of units (11/56) did not administer the vaccine. Of those units giving rotavirus vaccine there was considerable variation in practice with only 63% of such units (29/45) following the Joint Committee on Vaccination and Immunisation (JCVI) guidance to target all babies. Thirteen units gave rotavirus vaccine to selected infants based on a consultant decision made on individual cases and three units had specific exclusions related to surgical infants or neutropenia. Only 37% of units (17/45) had a written guideline for giving rotavirus vaccine in their unit. As well as variation in infants offered vaccination, we identified considerable variation in infection control precautions following vaccination. Following rotavirus vaccination, the JCVI state there is a potential for transmission through faecal material for up to 14 days.1 From our survey 20% of units (10/45) are not using any infection precautions following administration, 17% of units (8/45) use gloves and aprons for up to 1 week and 11% (5/45) use precautions for 48 h following administration of the vaccine. There is no national recommendation about infection precautions following rotavirus vaccination. It is clear that a large number of neonatal units are not following national guidance with regards to vaccination with many neonatal units yet to introduce rotavirus vaccination. It is important to explore the underlying reasons for this to ensure optimal uptake. Further data are necessary to determine how the vaccine is tolerated in vulnerable preterm infants, and also to inform infection control practices around administering live vaccines in high-risk clinical areas.
Contributors DD and NK developed the concept for the survey; SJ and BB developed and conducted the telephone survey and all contributed to writing the letter. Competing interests None. Provenance and peer review Not commissioned; internally peer reviewed. To cite Jaques S, Bhojnagarwala B, Kennea N, et al. Arch Dis Child Fetal Neonatal Ed 2014;99:F252. Accepted 7 February 2014 Published Online First 4 March 2014
▸ http://dx.doi.org/10.1136/archdischild-2014-306107 Arch Dis Child Fetal Neonatal Ed 2014;99:F252. doi:10.1136/archdischild-2014-306067
REFERENCES 1
2
3
Infant rotavirus vaccination programme – questions and answers for healthcare practitioners. Public Health England, 2013. Soriano-Gabarró M, Mrukowicz J, Vesikari T, et al. Burden of rotavirus disease in European Union countries. Pediatr Infect Dis J 2006;25(1 Suppl):S7–11. Giaquinto C, Van Damme P, Huet F, et al. Cost of community acquired pediatric rotavirus gastroenteritis in 7 European countires: the reveal study. J Infect Dis 2007;195(Suppl 1):S36–44.
Retraction notice Fazilleau L, Parienti JJ, Bellot A, Guillois B. NIDCAP in preterm infants and the neurodevelopmental effect in the first 2 years. Arch Dis Child Fetal Neonatal Ed Published Online First: 31 October 2013 doi:10.1136/archdischild-2012-303508.
This paper has been retracted because it contained errors in the data extraction and analyses that affect the results, figures and tables. Data from a study that had been published in two different journal articles were included twice in the analyses. There was an error in the description of the measures used for neurodevelopmental testing in the reporting of the results.
Siobhan Jaques, Bikash Bhojnagarwala, Nigel Kennea, Donovan Duffy Neonatal Unit, St. George’s Hospital, London, UK Correspondence to Dr Siobhan Jaques Neonatal Unit, St. George’s Hospital, London SW17 0QT, UK; [email protected]
Arch Dis Child 2014;99:F252. doi:10.1136/archdischild-2012-303508ret
Arch Dis Child May 2014 Vol 99 No 3
Downloaded from http://fn.bmj.com/ on June 6, 2015 - Published by group.bmj.com
Retraction notice
Arch Dis Child Fetal Neonatal Ed 2014 99: F252
doi: 10.1136/archdischild-2012-303508ret Updated information and services can be found at: http://fn.bmj.com/content/99/3/F252.1
These include:
Email alerting service
Receive free email alerts when new articles cite this article. Sign up in the box at the top right corner of the online article.
Notes
To request permissions go to: http://group.bmj.com/group/rights-licensing/permissions To order reprints go to: http://journals.bmj.com/cgi/reprintform To subscribe to BMJ go to: http://group.bmj.com/subscribe/
