A237 ROTAVIRUS VACCINE SAFETY IN INFANTS EXPOSED TO BIOLOGICS IN UTERO IN AN INFLAMMATORY BOWEL DISEASE POPULATION: A PROSPECTIVE COHORT STUDY
Notice bibliographique
Résumé
Abstract Background Biologics, the mainstay of therapy in patients with moderate-to-severe inflammatory bowel disease (IBD), undergo placental transfer during the second trimester of pregnancy and may remain detectable in the blood of exposed infants for up to 12 months. Due to concerns regarding the risk of immunosuppression and adverse events following immunization with live attenuated vaccines in infants exposed to biologics in utero, current guidelines recommend avoiding live vaccines in the first 6 to 12 months of life. Aims This study investigates whether the live rotavirus vaccine can safely be administered in infants exposed to biologics in utero. Methods We conducted a single-centre prospective cohort study, which included infants exposed to biologics in utero and born to mothers with IBD between October 1, 2020 and June 30, 2022. Infants were included in the study if they were assessed by Paediatric specialists at the Special Immunization Clinic (SIC) at SickKids Hospital (Toronto, Ontario). Mothers were followed by Gastroenterologists at the Special Pregnancy IBD Clinic at Mount Sinai Hospital (Toronto, Ontario). Data were collected on biologic agent exposure history, infant immune function testing, SIC recommendations for rotavirus vaccination, rotavirus vaccine series completion, and adverse events after immunization. Adverse events following immunization included fevers, vomiting, diarrhea, and/or intussusception within 42 days following immunization. Results 22 infants were included in the study. Of the 22 infants, 5 (22.7%) were exposed to infliximab in utero, 10 (45.5%) were exposed to adalimumab, 3 (13.6%) were exposed to vedolizumab, and 3 (13.6%) were exposed to ustekinumab. Of the 22 infants, 18 (81.8%) were recommended to receive the rotavirus vaccine by the SIC. 1 (0.05%) was not recommended to receive the vaccine due to neutropenia and low CD54 count on lymphocyte testing. The recommendation given to 3 infants is unknown. Of the 18 infants who were recommended to receive the vaccine, 16 (88.9%) received the vaccine and had no adverse events following immunization. 1 (6%) infant did not receive the rotavirus vaccine despite it being recommended due to parental choice. The rotavirus vaccination status and response in 1 infant recommended to receive the vaccine, is unknown. Conclusions Administration of the rotavirus vaccine in biologic-exposed infants did not result in adverse events in our study cohort. Although guidelines currently advise against live vaccinations in infants exposed to biologics in utero, specialist assessment of infant immune function can help encourage safe live vaccination uptake. Funding Agencies None
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».