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Assays for the Specific Growth Rate and Cell-binding Ability of Rotavirus
Published on: January 28, 2019
Time to begin a new chapter and expand rotavirus immunization
1Departments of Pediatrics and Medicine, Emory University School of Medicine, Atlanta, Georgia.
Insights
Rotavirus vaccination significantly reduced disease in infants and others via indirect protection. Expanding immunization could further improve public health, despite past safety concerns.
Area of Science:
- Pediatric infectious diseases
- Vaccinology
- Public health
Background:
- Rotavirus vaccine use in infants was limited due to intussusception risks with RotaShield.
- Rotavirus vaccination was implemented for young infants in 2008.
- Significant declines in rotavirus disease were observed post-implementation.
Observation:
- Declines in rotavirus disease benefited both vaccinated and unvaccinated individuals.
- Concerns about long-term effectiveness exist due to incomplete, non-lifelong immunity.
- Vaccination completion rates have plateaued below 70%.
Findings:
- Current strategies may leave a substantial susceptible population at risk.
- Indirect protection from infant vaccination benefits the unvaccinated.
Implications:
- Expanding rotavirus vaccination beyond current age recommendations could offer significant public health benefits.
- Benefits of expanded vaccination likely outweigh the minimal risks of intussusception.
- Further research into rotavirus vaccine efficacy and safety is warranted.
Abstract:
Rotavirus immunization has been limited to young infants owing to intussusception events noted with a prior rotavirus vaccine, RotaShield. Dramatic declines occurred in rotavirus-related disease beginning in 2008 after implementation of rotavirus vaccination in young infants. These declines occurred in vaccinated children and unvaccinated children and adults (through indirect protection). Despite these declines, reasons for concern exist about the durability of these declines. These reasons include an incomplete immune response that is not lifelong and rotavirus immunization completion rates that have plateaued at <70% of eligible children. Current rotavirus infant vaccination strategies and indirect protection of unvaccinated children will result in a large population of immunologically susceptible persons who will be at risk of rotavirus disease. Expansion of US rotavirus vaccination outside the current Advisory Committee on Immunization Practices recommended immunization age limits would provide important benefits that outweigh risk related to intussusception.
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