ReviewRotavirus vaccines: current prospects and future challenges
Section snippets
Burden of disease
Rotavirus infects all children early in life and although most first infections cause mild diarrhoea, 15–20% need treatment at a clinic, and 1–3% lead to dehydration needing hospitalisation (figure 1). The virus can be identified in 15–35% of children younger than 5 years treated in outpatient settings for diarrhoea and in 25–55% of those hospitalised.4, 11 About 600 000 children die every year from rotavirus, mainly in developing countries, and this figure represents about 5% of all deaths in
Rotavirus vaccines
The large burden of rotavirus disease has led many groups reviewing the need for new vaccines to select rotavirus as a high priority target for accelerated vaccine development. WHO's Diarrhoeal Disease Control Programme was the first to make this recommendation, which has been reaffirmed repeatedly by other international review groups, such as the Institute of Medicine (1985–86),52 the Children's Vaccine Initiative (1996), the Bill and Melinda Gates Foundation which funded the Children's
Challenges: scientific, logistic, financial
Many challenges remain before we can assess the full global effect that rotavirus vaccines can have to prevent severe and fatal cases of rotavirus infection in children. The question remains, will such live oral vaccines work as well in children in the poorest developing countries as they have in middle-income and developed countries where the original trials were done?10 Unlike parenteral vaccines, live oral vaccines against polio, cholera, and typhoid have not worked equally well in
Looking to the future
A new generation of rotavirus vaccines will soon be licensed in many countries and available for more widespread use. Early introduction into the private markets of these countries could lead to appreciable reductions in health-care costs and burden of disease within 2–4 years. Identifying the full value of these vaccines to prevent mortality from rotavirus in developing countries is still several years away and each of the vaccines must first show its effectiveness in poor populations in
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Interferon-λ3 alleviates intestinal epithelium injury induced by porcine rotavirus in mice
2023, International Journal of Biological MacromoleculesRotavirus and Other Viral Diarrhoea
2023, Manson's Tropical Diseases, Fourth EditionGenotype distribution and evolutionary analysis of rotavirus associated with acute diarrhea outpatients in Hubei, China, 2013–2016
2022, Virologica SinicaCitation Excerpt :From 1994 to 2014, 40% of diarrhea-related hospitalizations and 30% of diarrhea-related outpatients among children under 5 years old in China were caused by RVAs (Wu et al., 2016). The great diversity of predominant genotypes of RVAs may affect the efficacy of rotavirus vaccination programs (Akran et al., 2010; Aminu et al., 2010; Arista et al., 2006; Glass et al., 2006; Todd et al., 2010). Because of the significant fluctuation of circulating genotypes of RVAs in different research periods and populations, continued surveillance programs in the pre- and post-vaccination eras have been carried out.
Associations between biomarkers of environmental enteric dysfunction and oral rotavirus vaccine immunogenicity in rural Zimbabwean infants
2021, EClinicalMedicineCitation Excerpt :Interventions targeting EED may therefore not be effective in improving oral RVV performance, and further studies are needed to better understand the impact of the intestinal milieu on oral vaccine immunogenicity. Increased coverage of oral rotavirus vaccines (RVV) has contributed to global declines in diarrheal disease burden [1]. However, these vaccines fail to reach their full potential in regions of high child mortality.