Options for improving effectiveness of rotavirus vaccines in developing countries.
Rotavirus gastroenteritis is a leading global cause of mortality and morbidity in young children due to diarrhea and dehydration. Over 85% of deaths occur in developing countries. In industrialised countries, 2 live oral rotavirus vaccines licensed in 2006 quickly demonstrated high effectiveness, dramatically reducing severe rotavirus gastroenteritis admissions in many settings by more than 90%. In contrast, the same vaccines reduced severe rotavirus gastroenteritis by only 30-60% in developing countries, but have been proven life-saving. Bridging this "efficacy gap" offers the possibility to save many more lives of children under the age of 5. The reduced efficacy of rotavirus vaccines in developing settings may be related to differences in transmission dynamics, as well as host luminal, mucosal and immune factors. This review will examine strategies currently under study to target the issue of reduced efficacy and effectiveness of oral rotavirus vaccines in developing settings.
a Department of Paediatrics , Monash University, Melbourne, Australia; Enteric Virus Group, Murdoch Childrens Research Institute , Melbourne , Australia.
Marion S
MS
Tissera
b Enteric Virus Group, Murdoch Childrens Research Institute , Melbourne , Australia.
Daniel
D
Cowley
b Enteric Virus Group, Murdoch Childrens Research Institute , Melbourne , Australia.
Nada
N
Bogdanovic-Sakran
c Department of Microbiology , Monash University , Melbourne , Australia.
Melanie L
ML
Hutton
c Department of Microbiology , Monash University , Melbourne , Australia.
Dena
D
Lyras
d Enteric Virus Group, Murdoch Childrens Research Institute, Melbourne, Australia; Bill and Melinda Gates Foundation , Seattle , WA , USA.
Carl D
CD
Kirkwood
e Department of Paediatrics & The Ritchie Centre, Hudson Institute of Medical Research , Monash University, Melbourne, Australia; Infection and Immunity, Monash Children's Hospital, Monash Health, Melbourne, Australia; SAEFVIC, Murdoch Childrens Research Institute , Melbourne , Australia.
Jim P
JP
Buttery
D003906:Developing Countries; D005759:Gastroenteritis / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D012400:Rotavirus Infections / Q000453:epidemiology / Q000517:prevention & control*; D022243:Rotavirus Vaccines / Q000276:immunology*; D016896:Treatment Outcome
D022243:Rotavirus Vaccines
adjuvant; developing countries; effectiveness; efficacy; immunogenicity; rotavirus; vaccine