151: Rotavirus Vaccination in Neonatal Intensive Care Units: Safety and Feasibility
Bibliographic record
Abstract
Rotavirus (RV) is the most common vaccine-preventable cause of gastroenteritis (GE) in children. Currently, RV vaccination of infants in the NICU is not recommended. Infants in the NICU are however at very high risk of complications related to RVGE and a proportion will exceed age-eligibility for the first vaccine dose while admitted. RV vaccination was implemented in 2011 at a tertiary care NICU in response to this problem. We aimed to describe the safety and feasibility of a NICU-based vaccination program against RV. The RV vaccination program was implemented in July 2011. Hospitalized infants in a tertiary care NICU who received ≥1 dose of the RV5 vaccine were included. Of 62 infants vaccinated, 36 charts have been reviewed so far. Healthcare-associated (HA) RV cases from April 2009 to March 2013 have been identified through prospective HA infections surveillance and reviewed. Our NICU has an annual average of 393 admissions per year and 7229 patient-days during the study period. Since July 2011, 8.5% of NICU admissions were vaccinated against rotavirus. Twenty-two infants (61%) were males, the vaccinated population had a median gestation age of 33 weeks (IQR 28 6/7 to 38 3/7), a median birth weight of 1740 g (IQR 980 g to 2989 g) and a median length of stay of 79 days (IQR 55 to 110 days). The three main primary diagnostic categories of vaccinated infants were gastrointestinal (n=12), respiratory tract (n=7), and genetic (n=6). Thirty-six first doses, 11 second doses and eight third doses were administered at a median age of 61, 93 and 128 days respectively. Comparing each infant's median feeds in the seven days post-vaccine to their pre-vaccine feeds, there was a median change of +3.5 mL. The incidence rate of HA-RVGE prior to program implementation was 4.86 (95% CI 1.95 to 10) per 10,000 patient-days; the incidence rate in the intervention period (July 2011 to March 2013) has been 0 (95% CI 0 to 2.54) per 10,000 patient-days. The incidence rate ratio was 0 (95% CI 0 to 0.69). There was no case of HA-RVGE after the implementation of our RV vaccination program in our NICU. This study supports the safety and feasibility of a RV vaccination program in NICUs that aims to protect patients with the highest risk of RVGE complications once discharged.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.041 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".