A diagnostic quandary: Rotavirus vaccine associated diarrhea |
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| Affiliation: | 1. Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN 55902, United States;2. Division of Pediatric Allergy and Immunology, Mayo Clinic, Rochester, MN 55902, United States;1. Departmentof Health Sciences, University of Genoa, Genoa, Italy;2. ScientificAdvisor of UNESCO CHAIR “Anthropology of Health – Biosphere and Healing System”, Italy;3. University Museum System of Siena (Simus), History of Medicine, University of Siena, Siena, Italy;1. College of Medicine, University of Florida, Gainesville, FL, USA;2. Department of Orthopaedic Surgery and Sports Medicine, University of Florida, Gainesville, FL, USA;1. The Institute for Rare Diseases, Edmond and Lily Safra Children''s Hospital, Sheba Medical Center, Tel-Hashomer, Israel;2. Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel;3. The Danek Gertner Institute of Human Genetics, Sheba Medical Center, Tel-Hashomer, Israel;4. The Israeli Veterinary Services, Israeli Veterinary Services, Bet Dagan, Israel;5. Preventive Medicine Branch, IDF Medical Corps, Israel;6. Tel Aviv Department of Health, Ministry of Health, Tel Aviv, Israel;7. Central Virology Laboratory, Public Health Services, Ministry of Health, Chaim Sheba Medical Center, Ramat Gan, Israel;8. Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel;9. Pediatric Department and Infectious Disease Unit, Wolfson Medical Center, Holon, Israel;10. Mayanei Hayeshuah Medical Center, Bnei Brak, Israel;1. Microbiology & Immunology, Gifu Pharmaceutical University, Japan;2. Kikuchi Research Center, KM Biologics Co., Ltd, Japan;1. Hepatology Division, Baylor Scott and White Medical Center, Dallas, TX, United States;2. Baylor Scott and White Research Institute, United States;1. Central Research Laboratory, Kempegowda Institute of Medical Sciences, Bangalore, India;2. Department of Medicine, Division of Pulmonary, Allergy, and Critical Care, University of Alabama at Birmingham, AL, USA |
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| Abstract: | The patient is an otherwise healthy two-month-old boy who received the recommended vaccinations for his age group, which included the rotavirus pentavalent vaccine (RV5; RotaTeq) at his two-month well child visit. Three days later, he developed prolonged non-bloody diarrhea and was found to have persistently positive rotavirus antigen in his stool. Subsequent workup revealed mild defects in his functional T-cell immunocompetence. Genetic testing was obtained through the Invitae panel and was negative for hereditary forms of primary immunodeficiencies. The rotavirus antigen was found to have cleared from his stool around four months after receiving the RV5. Unfortunately, the source of the rotavirus infection was unable to be determined. The caregivers had misconceptions about the vaccine and the child’s immune system function which led to refusal of any further vaccinations. Healthcare providers should strive to develop honest and respectful relationships with parents to have thoughtful dialogues regarding vaccine safety and efficacy. |
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| Keywords: | Rotavirus Rotavirus vaccine Immunodeficiency Vaccine hesitancy |
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