CME on Rotavirus and Pneumococcal Diseases (Rotavirus/Pneumococcal
Disease Burden and Updated Pediatric Guidelines and ACIP Recommendation)
by Dr. Benjamin Co ( November 4, 2010 at Bellevue Hotel, Alabang, Muntinlupa)
By Lorenza Sioson,MD,DPPS
Summary:
Rotavirus Gastroenteritis
In the Philippines,
Annual estimates among children <5 years old
 84,590 clinic visits
 50,565 ER visits
 31,498 hospitalization
US ACIP and AAP Recommendations:
 Rotateq (RV5) and Rotarix (RV1) differ in composition and schedule of administration.
 The ACIP and AAP did not express preference for either vaccine.
 Routine administration:
1st dose: 6 weeks of age – 14 weeks, 6 days (max. age for 1st dose)
Minimum interval between doses: 4 weeks
All doses administered by: 8 months, 0 days
 Interchangeability of Rotavirus Vaccines:
Vaccination should be completed with the same product whenever possible.
If the product used for the previous doses is not available or unknown, the series should be
Completed with the available product.
 A total of 3 doses rotavirus vaccine should be administered if any dose in the series was
RV5, or if the product is unknown for any dose in the series.
 No studies in the interchangeability of vaccines have been conducted.
Rotavirus Gastroenteritis:
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a disease of multiple challenges
An underestimated burden
multiple symptoms, episodes and days
caused by multiple serotypes
Philippine data show that RVGE causes significant morbidity and peaks at a very young age.
Pentavalent Rotavirus Vaccine covers the most prevalent local types including G2.
Rotavirus vaccination resulted in reduction of diseases after vaccine introduction in the US.
 Delayed onset of rotavirus season
 Shorter duration of rotavirus season
 Reduction of rotavirus positive results
Rotavirus vaccination is recommended by WHO, US, ACIP, and PPS, PIDSP and PFV.
Pneumococcal Vaccine, Polyvalent
(Types 1,2,3,4,5,6B,7F,8,9N,9V,10A,11A,12F,14,15B,17F,18C,19A,20,22F,23F,33F)
Estimated annual disease burden worldwide:
 Pneumococcal infections are a major cause of morbidity and mortality worldwide.
 Streptococcus pneumonia is the #1 cause of bacterial pneumonia and a leading cause of
otitis media.
 Pneumococcal infections cause >1M annual deaths worldwide.
-most deaths in developing countries
-even in developed countries, invasive pneumococcal disease carries high mortality in
certain population groups (ie. Elderly people, esp. those living in institutions, and
patients with chronic organ failure, diabetes, nephritic syndrome, and
immunodeficiencies)
WHO Recommendations for Pneumococcal Polysaccharide Vaccination:
 The WHO recommends the polyvalent polysaccharide vaccine for selected groups >2years of
age with increased risk of pneumococcal disease, including:
- Healthy elderly patients >65 years old, particularly those living in institutions
- Patients with chronic organ failure, diabetes, nephritic syndrome, and certain
immunodeficiencies, particularly functional or anatomic asplenia.