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First rotavirus vaccine licensed: is there really a need?
R I Glass1, J S Bresee, U D Parashar
1Viral gastroenteritis Section, Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Insights
The first rotavirus vaccine prevents severe diarrhea in children. European health officials should reconsider its routine use due to the vaccine's proven efficacy and cost-effectiveness.
Area of Science:
- Pediatrics
- Vaccinology
- Public Health
Background:
- Rotavirus is a leading cause of severe diarrhea and hospitalizations in children globally.
- Despite its prevalence, European healthcare professionals question the necessity of rotavirus vaccination for infants.
- Disease burden and cost-effectiveness studies for rotavirus immunization are limited in Europe.
Purpose of the Study:
- To evaluate the need for rotavirus vaccine in routine infant immunization in Europe.
- To highlight the disease burden of rotavirus diarrhea in children.
- To discuss the cost-effectiveness of rotavirus immunization programs.
Main Methods:
- Review of existing epidemiological data on rotavirus disease burden in Europe and the United States.
- Analysis of the efficacy, safety, and cost-effectiveness of the first rotavirus vaccine.
- Comparison of disease incidence and hospitalization rates across different regions.
Main Results:
- Rotavirus causes 30-50% of diarrheal hospitalizations in children under 5.
- 1 in 40 to 1 in 77 children in Europe and the US may be hospitalized for rotavirus by age 5.
- The first rotavirus vaccine demonstrates good efficacy, low adverse effects, and positive cost-effectiveness.
Conclusions:
- An effective rotavirus vaccine is now available for preventing severe diarrhea in infants.
- European physicians and policymakers should reassess rotavirus epidemiology and disease burden.
- Routine rotavirus vaccination is recommended in the U.S. due to its benefits.
Abstract:
The first rotavirus vaccine was licensed in the United States on 31 August 1998 for the prevention of severe rotavirus diarrhea in children. Despite this landmark in new vaccines, many pediatricians and public health professionals in Europe are uncertain of the need for this vaccine for the routine immunization of infants. In Europe, ample evidence suggests that rotavirus is the most common cause of hospitalizations for severe diarrhea among children, but proper studies documenting the disease burden of rotavirus or the cost-effectiveness of a rotavirus immunization program have only been conducted in the United Kingdom following epidemiologic models used in the United States. All children are infected with rotavirus during their first few years of life, 30-50% of diarrheal hospitalizations among children <5 years are due to this agent, and, by the age of 5 years, between 1 in 40 and 1 in 77 children in Europe and the United States may be hospitalized for rotavirus. The first vaccine is a live, oral preparation combining four different serotypes of rotavirus and administered in three doses with other childhood immunizations. The good efficacy against severe rotavirus diarrhea, the low risk of adverse side effects and the positive cost-effectiveness equation have led the two major immunization advisory groups in the U.S. to recommend this vaccine for routine use in American infants. European physicians and policy-makers should re-examine the epidemiology and disease burden of rotavirus diarrhea now that an effective method of prevention is at hand.