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Rotavirus vaccines: development and use for the prevention of diarrhoeal disease
1University of Tampere, School of Medicine, Finland. lltive@uta.fi
Insights
Rotavirus vaccines significantly reduce severe rotavirus diarrhea in children. Oral immunization with live attenuated vaccines, like the rhesus-human reassortant tetravalent vaccine, proves effective in preventing illness.
Area of Science:
- Pediatrics
- Vaccinology
- Infectious Diseases
Background:
- Rotavirus infection is a leading cause of severe diarrhea and mortality in young children globally, particularly in developing nations.
- Natural immunity develops over the first few years of life, but vaccination offers a more immediate protective strategy.
- Improved hygiene alone has not significantly reduced the disease burden in developed countries.
Purpose of the Study:
- To evaluate the efficacy of live attenuated oral rotavirus vaccines in preventing severe rotavirus disease.
- To assess the development and application of rotavirus vaccine candidates, including reassortant strains.
Main Methods:
- Development of candidate vaccines through tissue culture adaptation and attenuation of bovine and rhesus rotaviruses.
- Improvement of heterologous rotaviruses by reassortment with human rotaviruses to express human VP7 surface antigens.
- Clinical evaluation of a licensed rhesus-human reassortant tetravalent (RRV-TV) rotavirus vaccine.
Main Results:
- The RRV-TV vaccine demonstrated 90% efficacy in preventing severe rotavirus gastroenteritis in Finland.
- While effective in developed countries, the vaccine's protective efficacy is lower in developing countries, suggesting a need for adjusted immunization schedules.
- Ongoing research investigates other candidate rotavirus vaccines, including bovine-human reassortants.
Conclusions:
- Live attenuated oral rotavirus vaccines are effective in preventing severe rotavirus diarrhea, a major childhood illness.
- Vaccine development strategies involving reassortment have yielded successful candidates like RRV-TV.
- Further research and potentially modified vaccination strategies are needed to optimize rotavirus vaccine effectiveness globally, especially in resource-limited settings.
Abstract:
Rotavirus causes annually 600 000 deaths of young children worldwide, mainly in developing countries. The burden of rotavirus disease is significant also in developed countries and has not diminished with improved hygiene. Natural protective immunity against severe rotavirus disease is built up during the first 2-3 years of life. Likewise, studies with live attenuated oral rotavirus vaccines have shown that the majority of severe episodes of rotavirus diarrhoea are preventable by oral immunization. Candidate rotavirus vaccines were first developed by tissue culture adaptation and attenuation of bovine and rhesus rotaviruses, both of which share the inner core VP6 group antigen with human group A rotaviruses. Subsequently, such heterologous rotaviruses were improved for use as human vaccines by reassortment with human rotaviruses; the resulting reassortants express human rotavirus VP7 surface antigens. A rhesus-human reassortant tetravalent (RRV-TV) rotavirus vaccine was licensed in the USA in 1998, and is recommended for universal immunization of healthy children; licensure in Europe is also imminent. In Finland, this vaccine has prevented 90% of severe episodes of rotavirus gastroenteritis. Protective efficacy of RRV-TV vaccine in developing countries is lower and a more intensive immunization schedule may be needed. Several other candidate rotavirus vaccines, including bovine-human reassortants, are being investigated.