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Assays for the Specific Growth Rate and Cell-binding Ability of Rotavirus
Published on: January 28, 2019
Comparison of virus shedding after lived attenuated and pentavalent reassortant rotavirus vaccine
Yu-Chia Hsieh1, Fang-Tzy Wu2, Chao A Hsiung3
1Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan.
Insights
Fecal shedding of rotavirus vaccines (RV5 and RV2) was compared in infants. While shedding rates were similar, infants receiving Rotarix (RV2) showed significantly higher viral loads than those receiving RotaTeq (RV5).
Area of Science:
- Pediatric Infectious Diseases
- Vaccinology
- Gastroenterology
Background:
- Rotavirus vaccines are crucial for preventing severe gastroenteritis in infants.
- Previous reports indicate potential transmission of vaccine strains to unvaccinated contacts.
- Understanding vaccine virus shedding is essential for assessing transmission risk.
Purpose of the Study:
- To compare fecal shedding of rotavirus vaccine strains RotaTeq (RV5) and Rotarix (RV2) in infants.
- To characterize the duration and viral load of shedding after vaccination.
- To evaluate potential differences in shedding between the two vaccine types.
Main Methods:
- Two groups of healthy infants received either RV5 or RV2 vaccine.
- Fecal samples were collected for one month post-vaccination.
- Virus shedding was detected using enzyme immunoassay (EIA) and real-time reverse transcription-polymerase chain reaction (RT-PCR).
- Statistical analysis (mixed effects logistic regression) compared shedding rates and viral loads.
Main Results:
- Rotavirus vaccine virus shedding was detected by RT-PCR in 80-90% of infants between days 4-7 post-first dose.
- Shedding was observed from day 1 up to 25-28 days in both vaccine groups.
- No significant difference in shedding rates was found between RV5 and RV2 recipients.
- Infants receiving RV2 shed significantly higher viral loads compared to RV5 recipients after both the first and second doses.
Conclusions:
- Rotavirus vaccine shedding occurs in infants vaccinated with either RV5 or RV2.
- While shedding rates are comparable, RV2 is associated with higher viral loads.
- Further observation is needed to determine the clinical significance of increased RV2 viral shedding.
Abstract:
Transmission of rotavirus vaccine or vaccine-reassortant strains to unvaccinated contacts has been reported. Therefore, it is essential to evaluate and characterize the nature of vaccine-virus shedding among rotavirus vaccine recipients. Two groups of healthy infants who received a complete course of RotaTeq (RV5) or Rotarix (RV2) were enrolled (between March 2010 and June 2011) to compare fecal shedding for one month after each vaccine dose. Shedding was assessed using both enzyme immunoassay (EIA) and real-time reverse transcription-polymerase chain reaction (RT-PCR). Eighty-seven infants (34 girls and 53 boys) were enrolled in the study. After the first vaccine dose, the peak time of virus shedding occurred between day 4 and day 7, with positive detection rates of 80-90% by real-time RT-PCR and 20-30% by EIA. In both groups, vaccine shedding occurred as early as one day and as late as 25-28 days. Mixed effects logistic regression analysis of real-time RT-PCR data showed no significant differences between two groups when shedding rates were compared after the first vaccine dose (odds ratio [OR] 1.26; P=0.71) or after the second vaccine dose (odds ratio [OR] 1.26; P=0.99). However, infants receiving RV2 shed significantly higher viral loads than those receiving RV5 when compared after the first vaccine dose (P=0.001) and after the second dose (P=0.039). In terms of shedding rates detected by real-time RT-PCR, vaccine uptake of RV5 or RV2 among infants in Taiwan was comparable. Clinical significance of higher shedding viral loads in RV2 should be further observed.
