Rotavirus vaccines

Abstract

Rotavirus is the leading cause of severe childhood gastroenteritis in both developed and developing countries and results in over half a million deaths each year, with over 120,000 deaths occurring annually in India. Rotaviruses are classified based on the proteins that make up the three layers of the virus and Group A rotaviruses are most important for human health. Human rotaviruses of VP7 genotypes G1-4, G9 and G12 and VP4 P genotypes P[4], P[6] and P[8] are predominant worldwide. Currently two Rotaviruses vaccines (Rotarix^®, GSK Biologicals and Rotateq^TM, Merck Research Laboratories), are licensed in many countries in the world, and in routine use in several national immunization programs. Other candidate vaccines are under development in India and other countries. Vaccines were licensed based on large trials conducted in several countries in Europe and America, which showed high efficacy against the common circulating rotavirus types. Recent data from developing countries indicates that vaccine efficacy is lower than seen in Europe and America, but still has a substantial public health impact. Based on these data, the World Health Organization has recommended that all national immunization program should adopt these vaccines, but considerations of cost and supply are important factors in determining more widespread use. Safe and effective vaccines are available and in development against this major cause of childhood morbidity and mortality, but their deployment in national immunization programs requires an evaluation of disease burden, cost-effectiveness and programmatic issues of delivery.