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Rotavirus vaccine for preventing diarrhoea
K Soares-Weiser1, E Goldberg, G Tamimi
1Department of Social Work, Bar Ilan University, 82 Jerusalem Street, Kfar-Saba, Israel.
The Cochrane Database of Systematic Reviews
|February 20, 2004
Summary
Rotavirus vaccines, particularly rhesus and human types, effectively prevent rotavirus and all-cause diarrhea in children. However, comprehensive safety and mortality data remain limited, necessitating further research in diverse economic settings.
Area of Science:
- Pediatrics
- Infectious Diseases
- Vaccinology
Background:
- Rotaviruses are a leading cause of severe diarrheal disease and mortality in children under five globally.
- Gastroenteritis caused by rotavirus disproportionately affects children in low- and middle-income countries.
Purpose of the Study:
- To evaluate the efficacy and safety of rotavirus vaccines in preventing rotavirus-associated diarrhea and death.
- To assess adverse events associated with rotavirus vaccination.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs) comparing rotavirus vaccines to placebo or no intervention.
- Searched multiple databases including Cochrane, MEDLINE, EMBASE, and LILACS up to October 2003.
- Data extraction and quality assessment performed independently by two reviewers.
Main Results:
- Sixty-four trials involving 21,070 children assessed bovine, human, and rhesus rotavirus vaccines.
- Efficacy varied by vaccine type, ranging from 22-89% for rotavirus diarrhea and 43-90% for severe rotavirus diarrhea.
- Rhesus rotavirus vaccines showed comparable efficacy in high- and middle-income countries; safety and mortality data were scarce and incomplete.
Conclusions:
- Rhesus rotavirus vaccines (e.g., RRV-TV) and human rotavirus vaccine 89-12 demonstrate efficacy in preventing rotavirus and all-cause diarrhea.
- Evidence regarding vaccine safety, mortality reduction, and prevention of severe outcomes is limited and inconclusive.
- Further RCTs, including those in low-income countries, are needed to strengthen the evidence base for rotavirus vaccines.