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Rotavirus vaccines: targeting the developing world.
J Infect Dis 2005; 192 Suppl 1:S160-6JI

Abstract

For the past 2 decades, rotavirus infection, the most common cause of severe diarrhea in children, has been a priority target for vaccine development. This decision to develop rotavirus vaccines is predicated on the great burden associated with fatal rotavirus disease (i.e., 440,000 deaths/year), the firm scientific basis for developing live oral vaccines, the belief that increased investment in development at this time could speed the introduction of vaccines in developing countries, and the appreciation that implementation of a vaccine program should result in a measurable decrease in the number of hospitalizations and deaths associated with rotavirus disease within 2-3 years. RotaShield (Wyeth-Ayerst), the first rotavirus vaccine licensed in the United States, was withdrawn after 9 months because of a rare association of the vaccine with the development of intussusception. In the developing world, this vaccine could still have had a measurable effect, because the benefits of preventing deaths due to rotavirus disease would have been substantially greater than the rare risk of intussusception. Two live oral vaccines being prepared by GlaxoSmithKline and Merck have completed large-scale clinical trials. The GlaxoSmithKline vaccine has been licensed in Mexico and the Dominican Republic, and the Merck vaccine could be licensed in the United States within 1 year; several other candidate vaccines are in earlier stages of testing. However, many challenges remain before any of these vaccines can be incorporated into childhood immunization programs in the developing world. First, vaccine efficacy, which has already been demonstrated in children in industrialized and middle-income countries, needs to be proven in poor developing countries in Africa and Asia. The safety of vaccines with regard to the associated risk of intussusception must be demonstrated as well. Novel financing strategies will be needed to ensure that new vaccines are affordable and available in the developing world. Decision makers and parents in developing countries need to know about this disease that has little name recognition and is rarely diagnosed. Finally, for the global effort toward the prevention of rotavirus disease to be successful, special efforts will be required in India, China, and Indonesia, because one-third of all deaths due to rotavirus disease occur in these countries, and because these countries depend almost entirely on vaccines manufactured domestically.

Authors+Show Affiliations

Viral Gastroenteritis Section, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. rglass@cdc.govNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16088799

Citation

Glass, Roger I., et al. "Rotavirus Vaccines: Targeting the Developing World." The Journal of Infectious Diseases, vol. 192 Suppl 1, 2005, pp. S160-6.
Glass RI, Bresee JS, Turcios R, et al. Rotavirus vaccines: targeting the developing world. J Infect Dis. 2005;192 Suppl 1:S160-6.
Glass, R. I., Bresee, J. S., Turcios, R., Fischer, T. K., Parashar, U. D., & Steele, A. D. (2005). Rotavirus vaccines: targeting the developing world. The Journal of Infectious Diseases, 192 Suppl 1, pp. S160-6.
Glass RI, et al. Rotavirus Vaccines: Targeting the Developing World. J Infect Dis. 2005 Sep 1;192 Suppl 1:S160-6. PubMed PMID: 16088799.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rotavirus vaccines: targeting the developing world. AU - Glass,Roger I, AU - Bresee,Joseph S, AU - Turcios,Reina, AU - Fischer,Thea K, AU - Parashar,Umesh D, AU - Steele,A Duncan, PY - 2005/8/10/pubmed PY - 2005/10/14/medline PY - 2005/8/10/entrez SP - S160 EP - 6 JF - The Journal of infectious diseases JO - J. Infect. Dis. VL - 192 Suppl 1 N2 - For the past 2 decades, rotavirus infection, the most common cause of severe diarrhea in children, has been a priority target for vaccine development. This decision to develop rotavirus vaccines is predicated on the great burden associated with fatal rotavirus disease (i.e., 440,000 deaths/year), the firm scientific basis for developing live oral vaccines, the belief that increased investment in development at this time could speed the introduction of vaccines in developing countries, and the appreciation that implementation of a vaccine program should result in a measurable decrease in the number of hospitalizations and deaths associated with rotavirus disease within 2-3 years. RotaShield (Wyeth-Ayerst), the first rotavirus vaccine licensed in the United States, was withdrawn after 9 months because of a rare association of the vaccine with the development of intussusception. In the developing world, this vaccine could still have had a measurable effect, because the benefits of preventing deaths due to rotavirus disease would have been substantially greater than the rare risk of intussusception. Two live oral vaccines being prepared by GlaxoSmithKline and Merck have completed large-scale clinical trials. The GlaxoSmithKline vaccine has been licensed in Mexico and the Dominican Republic, and the Merck vaccine could be licensed in the United States within 1 year; several other candidate vaccines are in earlier stages of testing. However, many challenges remain before any of these vaccines can be incorporated into childhood immunization programs in the developing world. First, vaccine efficacy, which has already been demonstrated in children in industrialized and middle-income countries, needs to be proven in poor developing countries in Africa and Asia. The safety of vaccines with regard to the associated risk of intussusception must be demonstrated as well. Novel financing strategies will be needed to ensure that new vaccines are affordable and available in the developing world. Decision makers and parents in developing countries need to know about this disease that has little name recognition and is rarely diagnosed. Finally, for the global effort toward the prevention of rotavirus disease to be successful, special efforts will be required in India, China, and Indonesia, because one-third of all deaths due to rotavirus disease occur in these countries, and because these countries depend almost entirely on vaccines manufactured domestically. SN - 0022-1899 UR - https://www.unboundmedicine.com/medline/citation/16088799/Rotavirus_vaccines:_targeting_the_developing_world_ L2 - https://academic.oup.com/jid/article-lookup/doi/10.1086/431504 DB - PRIME DP - Unbound Medicine ER -