Sex: U
Vaccine: RVX
Symptoms: COVID-19, Coinfection, Intensive care, Rotavirus infection, Rotavirus test positive
Clinical narrative: Suspected vaccination failure; Rotavirus co-infection; Covid-19 infection; This case was reported in a literature article and described the occurrence of suspected vaccination failure in a child patient who received Rotavirus vaccine for prophylaxis. March-April 2020; 9(5): 519-522.)   On an unknown date, the patient received Rotavirus vaccine (oral). On an unknown date, 3 years after receiving Rotavirus vaccine, the patient experienced vaccination failure (serious criteria hospitalization and GSK medically significant), rotavirus infection (serious criteria hospitalization) and covid-19 (serious criteria hospitalization). On an unknown date, the outcome of the vaccination failure, rotavirus infection and covid-19 were unknown.   It was unknown if the reporter considered the vaccination failure, rotavirus infection and covid-19 to be related to Rotavirus vaccine.  Additional details were provided as follows: This case was reported in a literature article and described the suspected vaccination failure, in a patient aged between 0-17-year-old of unspecified gender, who was vaccinated with Unspecified Rotavirus vaccine (manufacturer unknown) for prophylaxis.  The patient was a part of a study that aimed to characterizes the clinical and epidemiological characteristics of COVID-19 in children in the first month of known community transmission, from 5th March 2020 to 8th April 2020. [In this study, Data were submitted on laboratory-confirmed COVID-19 cases reporting. Additionally, results of COVID-19 laboratory tests were reported duplicated by person to determine the percentage of residents who tested positive for COVID-19]. No information on patient medical or family history or concurrent condition or concomitant medication was reported.  On an unknown date, the patient received unspecified rotavirus vaccine (administration site unspecified, dosage unknown, batch number not provided). The age at vaccination was not reported.  On an unspecified date between 5th March 2020 to 8th April 2020, 3 years after last recorded rotavirus vaccine administration date, the patient had laboratory confirmed Covid-19 infection. The patient was hospitalized and was evaluated for viral and bacterial co-infection with multiplex respiratory pathogen panels. The patient had positive rotavirus stool antigen and was diagnosed with Rotavirus co-infection. The patient required intensive care unit (ICU) admission. The patient did not meet. [In this study, reported presence of fever and dyspnea were significantly higher in hospitalized patients compared to non-hospitalized patients. Reported presence of fever and dyspnea were significantly higher in hospitalized patients compared to non-hospitalized patients. Of those hospitalized, all either had an underlying comorbidity or co-infection detected; 7 had an underlying comorbidity and 4 had coinfection. Three had a history of chronic lung disease, 2 had a history of cardiac or congenital heart disease, 2 had Trisomy 21, and 2 had immunodeficiency (1 with immune dysfunction related to a genetic disorder; 1 with recent myelosuppressive chemotherapy). One patient who required intensive care had an underlying condition and coinfection. At the time of manuscript submission, the no COVID-19 related pediatric deaths were reported in this cohort. Among 27 patients with known travel history, 2 reported travel within the 14 days prior to symptom onset. Forty (63%) had at least 1 additional household member with laboratory-confirmed COVID-19. Among the 34 unique households with multiple laboratory-confirmed infections, the median number of laboratory-confirmed infections was 2 (range, 2-5), and 31 households had at least 1 adult who also had a laboratory-confirmed infection. For 15 households for which all necessary data to determine transmission were available, 11 were adult-to-child, 2 were child-to-child, and 2 were child-to-adult. None of the 64 pediatric patients were associated with a recognized outbreak in a congregate setting]. The case was considered as suspected vaccination failure being dosing schedule unknown. The case was considered as serious due to suspected vaccination failure. Treatment was unknown. Outcome was not reported. The authors commented "Upon review of testing volume across the city, infants represented 17.5% (183/1044) of all who were known to be tested during this time period and 13% of all pediatric patients, similar to national data. In the infants accounted for 40% of all hospitalizations and 57% of ICU hospitalizations, and many were found to have underlying comorbidities or coinfection, supporting a heightened risk perception for this group of infants or suggesting that risk perception plays a role in hospitalization. A recent research letter revealed coinfection in 24 of 116 specimens positive for SARS-CoV-2; the youngest patient in the SARS-CoV-2 coinfection group was aged 9 years. While patients with coinfections did not differ significantly in age from those infected with SARS-CoV-2 only (mean age, 46.9 years vs 51.1 years, a 4.2-year difference), no specific pediatric data on coinfection and disease severity were presented. Enhanced case investigation of all hospitalized revealed that, as with infants, underlying comorbidities and coinfection might have contributed to severe disease. Of concern was the finding that the majority of cases had multiple persons with confirmed COVID-19 living at home".  The authors concluded "Enhanced case investigation of hospitalized patients revealed that underlying comorbidities and coinfection might have contributed to severe disease. Given frequency of household transmission, healthcare providers should consider alternative dispositional planning for affected families of children living with comorbidities". This article is not available for regulatory submission due to copyright restriction.