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Published on: January 28, 2019
Post-licensure experience with rotavirus vaccination in high and middle income countries; 2006 to 2011
Ben A Lopman1, Daniel C Payne, Jacqueline E Tate
1Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, United States. blopman@cdc.gov
Insights
Rotavirus vaccines significantly reduce severe diarrhea hospitalizations in children globally. Post-licensure studies show these vaccines also provide herd immunity, benefiting unvaccinated populations and impacting rotavirus genotype diversity.
Area of Science:
- Pediatric Infectious Diseases
- Vaccinology
- Public Health
Background:
- Rotavirus is a leading cause of severe diarrheal disease in children under five worldwide.
- Two rotavirus vaccines were introduced in 2006, with adoption in numerous countries, particularly high- and middle-income settings.
Purpose of the Study:
- To summarize post-licensure findings on rotavirus vaccine effectiveness.
- To evaluate vaccine impact on healthcare utilization, mortality, and safety.
- To explore vaccine-induced selective pressure on rotavirus genotypes.
Main Methods:
- Review of post-licensure vaccine effectiveness studies.
- Analysis of healthcare utilization and mortality data.
- Assessment of vaccine safety, including intussusception and adventitious viruses.
- Investigation of rotavirus genotype diversity changes.
Main Results:
- Significant reductions in rotavirus hospitalizations observed in vaccinated populations.
- Demonstrated indirect benefits (herd immunity) in unvaccinated groups.
- Impacts on gastroenteritis mortality noted in some regions.
- Safety profiles evaluated, including intussusception risk and adventitious virus detection.
Conclusions:
- Rotavirus vaccines are effective in reducing severe diarrhea and hospitalizations in children.
- Widespread vaccination confers herd immunity, extending benefits to unvaccinated individuals.
- Ongoing monitoring is crucial for vaccine safety and understanding evolutionary pressure on rotavirus genotypes.
Abstract:
Rotavirus causes one-third to one-half of severe diarrheal disease in children under the age of five years worldwide. In 2006 two rotavirus vaccines became available and, in the intervening years, approximately thirty countries have introduced them into their immunization programs, primarily in high-income and middle-income settings. Major reductions in rotavirus hospitalizations have been observed in a number of these locations, and in select countries, there have been impacts on gastroenteritis mortality associated with rotavirus vaccine introduction. In addition to these direct health benefits, reduced gastroenteritis risk has been documented in unvaccinated groups, including older children and adults, suggesting indirect benefits (i.e. herd immunity). In this paper, we summarize what has been learned from programs studying post-licensure vaccine effectiveness, impact on health-care utilization and death, safety issues (namely, intussception and the detection of adventitious viruses) and the potential selective pressure of vaccination on the diversity of rotavirus genotypes.
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