A Multi-Center, Qualitative Assessment of Pediatrician and Parental Perspectives on the Detection of Porcine Circovirus in Rotavirus Vaccines

Background: In 2010, novel laboratory techniques found that US-licensed rotavirus vaccines contained porcine circovirus (PCV) or its DNA fragments. 

Objectives: Our objective was to understand pediatricians’ and parents’ perspectives on this finding to inform the development of communication materials.

Methods: We conducted three iterations of focus groups for pediatricians and non–vaccine hesitant parents at Seattle Children’s Hospital, WA, Cincinnati Children’s Hospital Medical Center, OH, and the University of Rochester Medical Center, NY.  Focus groups explored perceptions of rotavirus disease, rotavirus vaccination, detection of PCV in rotavirus vaccines, and how to communicate these topics.

Results: Pediatricians understood firsthand the success of rotavirus vaccines in preventing severe pediatric acute gastroenteritis.  They measured this benefit against the theoretical risks of PCV in rotavirus vaccines, determining overall that the PCV finding was of no clinical significance.  Particularly influential was the realization that the large randomized, clinical trials that found both vaccines to be highly effective and safe were conducted with PCV already in the vaccines.  Most parents supported the ideal of full disclosure regarding vaccination risks and benefits.  However, with a scientific topic of this complexity, simplified information regarding PCV in rotavirus vaccines seemed frightening and suspicious, while detailed information was frequently overwhelming.  Parents often remarked that if they did not understand a medical or technical topic regarding their children’s health, they relied on their pediatrician’s guidance.  Many parents and pediatricians were concerned that those who abstain from pork consumption for religious or personal reasons may have unsubstantiated fears of the PCV finding.

Conclusions:  Pediatricians considered the detection of PCV in rotavirus vaccines a “non-issue” and reported little hesitation in continuing to recommend the vaccines.  Parents desired transparency but ultimately trusted their pediatrician’s recommendation.  Communicating this topic to pediatricians and parents requires sensitivity to a broad range of technical understanding and personal concerns.