ATLANTA — Severe combined immune deficiency is a contraindication to receipt of the rotavirus vaccine.
On Dec. 23, 2009, the Food and Drug Administration approved a request from Merck & Co. to add severe combined immune deficiency (SCID) as a contraindication to the RotaTeq product label. After that, the Centers for Disease Control and Prevention recommended that the contraindication apply to both Rotateq and the other licensed rotavirus vaccine, GlaxoSmithKline's Rotarix, Dr. Catherine Yen of the CDC's division of viral diseases said at the winter meeting of the CDC's Advisory Committee on Immunization Practices.
In March 2009, the CDC received reports of two infants diagnosed with SCID who had infection with the pentavalent rotavirus vaccine (RV5, Rotateq). Since then, an additional four cases have been reported in the United States, and there was one published case from Australia. The seven confirmed cases—three males and four females—ranged in age from less than 1 week to 11 months.
All had one or more coinfections, including five patients with the opportunistic fungal agent Pneumocystis jirovecci, one with salmonella, and one with Escherichia coli.
Five patients were treated by bone marrow transplant, and the other two were awaiting transplant at the time of the data review, Dr. Yen said.
The CDC will continue to monitor reports of rotavirus vaccine infection in infants with SCID.
In related news, the CDC's Advisory Committee for Heritable Disorders in Newborns and Children recommended on Jan. 21, 2010, adding SCID to the core panel for uniform newborn screening. The recommendation is currently awaiting approval by the Department of Health and Human Services.
Disclosures: None reported.