An illuminating example is the case of Rotashield, a rhesus reassortant rotavirus vaccine, which was introduced for routine use in the United States in the late 1990s. Within 9 months of its introduction, cases of intussusception were reported by the CDC to be temporally associated with the administration of the initial vaccine dose. This report led first to the cessation of the vaccine's use and subsequently to its withdrawal from the market and the discontinuation of its production. The withdrawal of the vaccine in the United States made its use impossible in developing countries, where the risk of any. | Chapter 116. Immunization Principles and Vaccine Use Part 10 An illuminating example is the case of Rotashield a rhesus reassortant rotavirus vaccine which was introduced for routine use in the United States in the late 1990s. Within 9 months of its introduction cases of intussusception were reported by the CDC to be temporally associated with the administration of the initial vaccine dose. This report led first to the cessation of the vaccine s use and subsequently to its withdrawal from the market and the discontinuation of its production. The withdrawal of the vaccine in the United States made its use impossible in developing countries where the risk of any increase in intussusception would have been dramatically outweighed by the benefit of decreased rotavirus mortality rates. It is now apparent that the susceptibility to intussception is age related with virtually no events in children 90 days of age. Almost a decade later a new rotavirus vaccine has been licensed in the United States and recommended for routine use beginning at 2 months of age. In the interim some 4-5 million infants have died of rotavirus diarrhea in the developing world most of these deaths could have been prevented by the original rhesus rotavirus vaccine. Vaccine components including protective antigens animal proteins introduced during vaccine production and antibiotics or other preservatives or stabilizers can certainly cause allergic reactions in some recipients. These reactions may be local or systemic including urticaria and serious anaphylaxis. The most common extraneous allergen is egg protein derived from the growth of measles mumps influenza and yellow fever viruses in embryonated eggs. Gelatin used as a heat stabilizer has been implicated in rare but severe allergic reactions. Local or systemic reactions probably due to antigen-antibody complexes can result from the too frequent administration of vaccines such as Td or rabies vaccine. Because live-virus vaccines can interfere .
