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rotavirus vaccines

rotavirus infection is very contagious; it spreads when infants or children come into contact with an infected person’s body fluids or feces, or items. most common age group is between 3 months to 35 months old.

infection is transmitted through stools to the mouth of another child called as fecaloral route of transmission. the virus can stand long on hands for hours.

the introduction of rotavirus vaccine helped protecting children from virulent rotavirus which is the leading causing of severe diarrhea in infants and children. more than 6,00,000 young children die and approximately 2.4 million hospitalize annually from rotavirus disease. because of the tremendous global burden of rotavirus, who has prioritized vaccine development and introduction to control this disease.

history says:

• human rotavirus was first isolated by ruth bishop in 1973.

• 1980, efforts were made to develop rotavirus vaccine

• 1998, rotavirus vaccine was licensed and introduced as live attenuated rhesus rotavirus vaccine (rotashield) but lately withdrawn in 1990 after reports of intussusceptions among vaccinated children

• 2006, two new oral rotavirus vaccines were licensed and introduced

rotavirus vaccine:

• introduction of rotavirus vaccines in national vaccine policy along with other childhood vaccines may result in significant reduction in mortality in children in poor socioeconomic countries

• four major structural and nonstructural proteins are important for vaccine development

currently licensed vaccine in use:

two safe and effective vaccines are now licensed in 100 countries. in april 2009, who provided a recommendation for global introduction of these vaccines in national immunisation programe of developing countries worldwide.

• rotarix (rvi, glaxosmithkline)

• rotateq (rv5, merck)

human bovine rotavirus reassortant vaccine (rotateq)

• manufactured by merck

• licensed by fda in 2006

• pentavalent human-bovine reassortant live attenuated, oral vaccine

• contains five live reassortant rotaviruses

• schedule- 3 oral doses beginning at 6 to 12 weeks of age with 1-2 months interval

• efficacy- in large clinical trial conducted primarily in us and finland, it showed an efficacy of 98% against severe rotavirus gastroenteritis. 59% reduction in admissions from all cause gastroenteritis was noted

human rotavirus vaccine (rotarix)

• it is manufactured by glaxosmith kline

• licensed by fda in 2008

• it’s a monovalent vaccine

• schedule- 2 dose schedule at 2 months and 4 months of age

• it protects 85% from severe rotavirus associated diarrhea and 100% from most severe dehydrating rotaviral gastroenteritis

issues with rotateq and rotarix:

• rotarix and rotateq vaccine were recently found to be contaminated with porcaine circovirus viral dna and were temporarily suspended by us fda in march 2010

• it was proven that porcaine circovirus did not impose any threat to human and thus both vaccines were declared safe

vaccines in development:

• an indian made rotavirus vaccine, rotavac which is 116e strain and is given in 3 doses each 4 weeks apart

• other vaccines are by bharat biotech in india

to overcome the disease burden due to rotaviral infection, vaccination against rotavirus is a necessity and we are quite successful in reducing the morbidity and mortality rate due to rotaviral infection among infants and young children.