No impact of rotavirus vaccination on childhood seizure hospitalizations in England
Author(s): ,
Rachael Biggart
Affiliations:
Bristol Royal Infirmary, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
,
Adam Finn
Affiliations:
Bristol Royal Hospital for Children, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
Robin Marlow
Affiliations:
Bristol Royal Hospital for Children, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
PHE ePoster Library. Biggart R. 03/20/18; 205938; 12630
Rachael Biggart
Rachael Biggart
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Abstract
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Abstract Background:Studies have identified rotavirus infection as an under-recognised cause of childhood seizures. In the US a large retrospective cohort study found in the year following rotavirus vaccination (RV) a 20% reduction in the risk of seizures requiring emergency department (ED) attendance or hospital admission. England is opportunely placed to explore unintended benefits of RV, given its well-defined introduction into our immunisation schedule in 2013 and high uptake (>95%).Methodology:Hospital Episodes Statistics (HES) are centralised records of all NHS hospital admissions in England. Within this dataset, we identified admissions with febrile and afebrile seizures in children (ICD-10 codes; G40*, G41*, R56.0*) between April 2007 and March 2017; fitting separate regression models for this count data, offsetting for English population changes and with vaccine use as a covariate.Results:Our 10-year time series analysis found no change in admission patterns for afebrile seizures and, predating RV rollout, a decreasing trend in admissions with febrile convulsions. The negative binomial distribution provided the best fit to the data, however our model did not detect a statistically significant association between RV and admission with febrile (p=0.84), afebrile (p=0.83) or all (p=0.93) seizures.Conclusions:Despite not finding a protective association, it remains important to document changing baseline seizure admission rates, given their significant healthcare resource use. The strength of this ecological study is its robust size, comparing ten year trends across the whole of England. A limitation is its selection in solely examining hospital admissions. Building on this piece of work we are going to conduct a similar analysis on presentations to ED with childhood seizures. Funding The School of Social and Community Medicine (SSCM), University of Bristol, has a Data Sharing Agreement (DSA; NIC-1785-X7K1V) with the HSCIC for HES Admitted Patient Care data. The purchase of these data was funded by NIHR CLAHRC West.
Abstract Background:Studies have identified rotavirus infection as an under-recognised cause of childhood seizures. In the US a large retrospective cohort study found in the year following rotavirus vaccination (RV) a 20% reduction in the risk of seizures requiring emergency department (ED) attendance or hospital admission. England is opportunely placed to explore unintended benefits of RV, given its well-defined introduction into our immunisation schedule in 2013 and high uptake (>95%).Methodology:Hospital Episodes Statistics (HES) are centralised records of all NHS hospital admissions in England. Within this dataset, we identified admissions with febrile and afebrile seizures in children (ICD-10 codes; G40*, G41*, R56.0*) between April 2007 and March 2017; fitting separate regression models for this count data, offsetting for English population changes and with vaccine use as a covariate.Results:Our 10-year time series analysis found no change in admission patterns for afebrile seizures and, predating RV rollout, a decreasing trend in admissions with febrile convulsions. The negative binomial distribution provided the best fit to the data, however our model did not detect a statistically significant association between RV and admission with febrile (p=0.84), afebrile (p=0.83) or all (p=0.93) seizures.Conclusions:Despite not finding a protective association, it remains important to document changing baseline seizure admission rates, given their significant healthcare resource use. The strength of this ecological study is its robust size, comparing ten year trends across the whole of England. A limitation is its selection in solely examining hospital admissions. Building on this piece of work we are going to conduct a similar analysis on presentations to ED with childhood seizures. Funding The School of Social and Community Medicine (SSCM), University of Bristol, has a Data Sharing Agreement (DSA; NIC-1785-X7K1V) with the HSCIC for HES Admitted Patient Care data. The purchase of these data was funded by NIHR CLAHRC West.
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