Rotavirus vaccination: A concise review

University of Tampere, Vaccine Research Centre, Tampere, Finland.
Clinical Microbiology and Infection (Impact Factor: 5.77). 07/2012; 18 Suppl 5(s5):57-63. DOI: 10.1111/j.1469-0691.2012.03981.x
Source: PubMed


Clin Microbiol Infect 2012; 18 (Suppl. 5): 57–63
Live attenuated oral rotavirus vaccines were tested for proof-of-concept in the early 1980s, the first vaccine (RotaShield®, Wyeth) was introduced in 1998 but was subsequently withdrawn because of association with intussusception, and the two currently licensed vaccine (Rotarix®, GlaxoSmithKline, and RotaTeq®, Merck) were introduced in 2006. Before licensure both vaccines were extensively tested for safety (for intussusception) and efficacy in trials comprising in over 60 000 infants each. Rotarix is a single-strain human rotavirus vaccine (RV1) and RotaTeq is a combination of five bovine–human reassortant rotaviruses (RV5). Although the composition of the two vaccines is different, their field effectiveness and, largely, mechanism of action are similar. Both prevent effectively severe rotavirus gastroenteritis (RVGE) but are less efficacious against mild RVGE or rotavirus infection. Field effectiveness of these vaccines in Europe and the USA against severe RVGE has been above 90% and in Latin America around 80%. Trials in Africa have yielded efficacy rates between 50 and 80%. Rotavirus vaccination has been introduced into the national immunization programmes of about 20 countries in Latin America, with Brazil and Mexico as leading countries, as well as in the USA, Australia and South Africa. Introduction into other African countries will start in 2012. In Europe, Belgium, Luxembourg, Austria and Finland and five federal states of Germany have introduced universal rotavirus vaccination. The reasons for the slow progress in Europe include low mortality from RVGE, unfavourable cost–benefit calculations in some countries, and concerns that still exist over intussusception.

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    • "likely be most beneficial (Mead, 2014). For example, commercially available mucosal vaccines against other enteric pathogens such as rotavirus, that are live and attenuated, have achieved considerable success in disease prevention and control in children in developed countries (Pasetti et al., 2011), but lower protection in children in developing countries (Vesikari, 2012). The use of an attenuated Cryptosporidium strain could therefore result in better immunological responses and protection from symptomatic disease and/ or infection. "
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    ABSTRACT: Cryptosporidium is an enteric parasite that is considered the second greatest cause of diarrhoea and death in children after rotavirus. Currently, 27 species are recognized as valid and of these, Cryptosporidium hominis and Cryptosporidium parvum are responsible for the majority of infections in humans. Molecular and biological studies indicate that Cryptosporidium is more closely related to gregarine parasites rather than to coccidians. The identification of gregarine-like gamont stages and the ability of Cryptosporidium to complete its life cycle in the absence of host cells further confirm its relationship with gregarines. This opens new avenues into the investigation of pathogenesis, epidemiology, treatment and control of Cryptosporidium. Effective drug treatments and vaccines are not yet available due, in part, to the technical challenges of working on Cryptosporidium in the laboratory. Whole genome sequencing and metabolomics have expanded our understanding of the biochemical requirements of this organism and have identified new drug targets. To effectively combat this important pathogen, increased funding is essential. Copyright © 2015. Published by Elsevier Ltd.
    Full-text · Article · Mar 2015 · International Journal for Parasitology
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    • "c o m / l o c a t e / m e e g i d Two rotavirus vaccines have been licensed in 2006 and are now available in 18 countries. Since their introduction, an effectiveness of 85–90% has been estimated (Vesikari, 2012). Starting from May 2012, Sicily introduced universal rotavirus vaccination in the regional vaccine schedule. "
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    ABSTRACT: Uninterrupted surveillance conducted in Palermo, Sicily, for 27 years (1985 to 2012) detected rotavirus infection in 32.7% of 6522 children <5 years of age, hospitalised at the ‘‘G. Di Cristina’’ Children’s Hospital of Palermo. Increased rotavirus activity usually occurred from the beginning of winter to mid-spring. G1P[8] rotaviruses were the prevalent strains in most of the years and were only occasionally overcome by G9P[8], G4P[8] or G2P[4]. The circulation of non-G1P[8] strains was discontinuous and fluctuating. Phylogenetic analyses revealed an heterogeneous population of viruses within each genotype, with different lineages and sublineages emerging over the time. Amino acid substitutions in both VP7 and VP8∗ antigenic epitopes were generally associated with different lineages/sublineages, emerging sequentially and replacing partially or completely the former strains. The present study summarises one of the longest surveillance activities conducted in the European continent, offering a useful temporal observatory of rotavirus epidemiology and strains variation and evolution in a settled population.
    Full-text · Article · Dec 2014 · Infection, genetics and evolution: journal of molecular epidemiology and evolutionary genetics in infectious diseases
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    • "Clinicians were more comfortable with parents refusing certain vaccines than others (Table 3). Vaccines are listed in order of their year of licensure in the United States [21] [22] [23] to examine the hypothesis that providers would be more comfortable with parents refusing recently introduced vaccines (this order was not observed in the design of the survey); however, no time trend for comfort with vaccine refusal was observed. Compared to polio vaccine, the only two vaccines for which providers were more comfortable with parents refusing were hepatitis B (16%; 95% CI = 6.1–18.0) "
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    ABSTRACT: Background As exemptions to school-entry requirements rise, vaccination rates in Arizona school children are approaching levels that may threaten public health. Understanding the interactions physicians have with vaccine-hesitant parents, as well as the opinions physicians hold regarding vaccination, exemption, and exemption policies, are critical to our understanding of, and ability to affect, vaccination exemption rates among children. Methods Survey responses were elicited from practitioners listed in The Arizona Partnership for Immunization and the Arizona Medical Association databases using a multi-pronged recruitment approach. Respondents provided data regarding their practice, comfort with parental refusal of individual vaccines, opinions about the beliefs held by parents that seek exemptions, parent education strategies, issues regarding providing care to unvaccinated children, and potential changes to Arizona policy. Results A total of 152 practitioners providing care to a wide geographic and economic population of Arizona responded to the survey. Respondents were generally strong advocates of all immunizations but were more accepting of parents’ desires to refuse hepatitis B and rotavirus vaccines. Almost all providers indicated that they see patients whose parents request to refuse or delay from vaccinations at least occasionally (88% and 97%, respectively). Only 37% of respondents indicated that they would be supportive of a policy requiring them to sign off on a parent's decision to refuse vaccination. Conclusions Vaccination providers in Arizona are generally very supportive of childhood immunizations but have varying comfort with exemption from individual vaccines. Responding providers tended to not support a requirement for a physician's signature for vaccine exemptions due to varying concerns regarding the implementation of such a practice.
    Full-text · Article · Jun 2014
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