Pediatricians: ‘Now vaccinate against rotavirus to relieve healthcare’

Almost all children under the age of five go through the rotavirus. It is a contagious disease in which inflammation of the stomach and intestines occurs. This also leads to vomiting and diarrhea. In many children the disease is mild, yet tens of thousands of parents visit the doctor with their child every year. Every year, 2500 to 4700 children also end up in hospital with dehydration symptoms due to the rotavirus, many of whom are healthy children. Five to seven children a year die from the effects of the virus.

“Any measure we can take to relieve healthcare is welcome,” says Károly Illy, chairman of the Dutch Pediatric Association (NVK). “Our pediatric wards in hospitals have hardly any corona patients, but the nurses from those wards are deployed in Covid wards.”

Infants already receive the rota vaccine as standard in Belgium, Germany and England. Vaccinating everyone in the Netherlands would reduce the number of hospital admissions by 85 percent, the Health Council stated in a recommendation to the Ministry of Health, Welfare and Sport in 2017. Because of the price tag attached to it, it was then decided not to introduce the vaccine ‘universally’.

Vulnerable children

As of last summer, therefore, only vulnerable children – for example premature babies – would be vaccinated. This was canceled at the last minute, because corona prevented the consultation offices from introducing it on time and because the vaccine would be much less effective in that group. It would protect only 30 percent of children in those at-risk groups, instead of more than 80 percent among healthy children.

Pediatrician Károly Illy of the Rivierenland Hospital in Tiel sees nurses from the children’s wards who are used to help Covid patients. Admissions and surgeries to be scheduled in advance are postponed due to corona. Air is needed, he wants to say. “It is in everyone’s interest to relieve healthcare as much as possible,” he says, as chairman of the NVK.

This is done, among other things, by the fireworks ban, so that there is no influx of injured people with old and new. But it could also be done by quickly introducing the rotavirus vaccine for all young children, says Illy. “The rotavirus leads to a lot of illness and many hospital admissions. And there is a simple way to protect children – the vaccine – and thus reduce the flow to care. It also helps the GPs, who are going to be busy with the corona vaccinations. ”

Deadly

Children’s wards fill up quickly every now and then due to various viral infections. Last winter, children with the RS virus – a cold virus – had to be transferred to Belgian hospitals because there were no beds available here. Biggest Problem: Shortage of staff. “The number of beds in the pediatric ward is not limited by the number of pediatricians or administrative staff, but by the number of nurses. That is why sometimes beds have to be closed, ”says Dasja Pajkrt, specialist in infectious diseases among children at the AMC in Amsterdam. “That shortage is now only more acute due to corona.”

In addition to the RS virus, for which there is no vaccine yet, the rotavirus – a type of stomach flu – brings several thousand children to the hospital every year. Virtually all children under the age of five go through the rotavirus. Some of the parents seek help from the GP with their sick child, some 3,500 children a year require more specialist care due to dehydration symptoms. Five to seven children die a year, often born prematurely or with congenital anomalies.

The solution to drastically reduce the number of illnesses has been within reach for years. There has been an excellent vaccine since 2006, which reduces the number of serious infections and hospital admissions by 85 percent. That vaccine is now only available to parents who pay for it out of pocket; Admission to the National Immunization Program has been disputed for some time. The Health Council advised the Ministry of Health in 2017 to vaccinate all young children against the rotavirus. The cost is a major drawback. The droplets – no injection – cost 135 euros per child, times 175,000 babies per year, which is more than the hospital costs.

Prices

But, as rotavirus expert Patricia Bruijning of UMC Utrecht already stated at the time, there is – literally – something to be bargained for. “With large-scale government purchasing of vaccines, the price per vaccine can be considerably lower. In this way, a more favorable price for rotavirus vaccines has been negotiated in Great Britain. There, the vaccine is included in the infant program. ”

Emeritus professor of paediatrics Ronald de Groot of Radboudumc states that ‘we are already ten years late’ with the introduction of the vaccine. He has repeatedly urged both the Health Council and the Ministry of Health, Welfare and Sport to include them in the National Immunization Program. “All countries around us are already vaccinating against rota. It is a destructive file, and then I print it properly. It has been delayed time and time again, partly because the disease is said to be not serious enough: relatively few children die from it, ”he says. “But then the preventive aspect is hardly appreciated. If you, as a parent, end up in the hospital with a few months old, critically ill baby, then that is a mess. Isn’t that serious enough? ”

Next year, the Health Council will look at the vaccine again, it is planned, but Illy hopes that it can now be urgently due to corona. If the ministry sees the plan, there are still a few hurdles to overcome. The vaccine must then be put out to tender and there must be a few organizational steps to ensure that the consultation offices can start. Illy: “But it is easy to fit in. It’s a drop vaccine that babies are given by mouth, and that can be done if they get the other vaccines at two and three months. ”

Winter months

Starting now would not be too late, says NVK chairman Illy. “We will be vaccinating against the corona virus throughout 2021, so for the time being, the concern is still busy with that. The countless operations delayed by corona also have to be made up for, so any measure we can take to relieve healthcare is very welcome. ” De Groot adds: “Every year in the winter months there is enormous pressure on the beds in the children’s wards, due to the RS virus, influenza and rota. This vaccine takes that peak off. ”

For the time being, the Ministry of VWS is sticking to the ‘normal route’, a spokesman said in a response. “The Health Council will advise on the vaccine in 2021. We are not asking for acceleration, because we are already asking a lot of advice, especially now in corona time. Every topic they consider is important for public health and they must also have the opportunity to look at it thoroughly. ”

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