Rotavirus Vaccine: Living Up to Expectation

Rotavirus causes acute gastroenteritis and has been a significant cause of morbidity and mortality among young children. Globally, it has been associated with approximately 40% of all childhood hospitalizations for diarrhea and vomiting in children younger than 5 years of age. In 2006, biologic manufacturers were finally able to develop vaccines against this deadly virus.

When initially introduced, the rotavirus vaccines were used only in middle-to-high income countries that had strong vaccine delivery infrastructures. The World Health Organization (WHO) had concerns that in low income settings, incomplete vaccine penetration would cause performance failure. In 2009, WHO reassessed its position and expanded its recommendations, stating that these vaccines should be used in all countries.

Researchers from the CDC in Atlanta, Georgia, recently published a study that looked at rotavirus vaccinations’ global impact. Published in the Journal of Infectious Disease, this review indicates that these vaccines have substantially decreased rotavirus-related hospitalizations.

The researchers examined the occurrence of disease 1 year post-vaccination in 2 age groups: children younger than 1, and children younger than 5 years of age. The impact of rotavirus vaccination was similar and positive in both groups. The median reduction in hospitalizations for acute gastroenteritis was 38%. It was 46% in countries that had previously reported high child mortality rates.

Overall, 67% of hospitalizations and emergency department visits were avoided after introduction of the rotavirus in the 27 countries reviewed.

Countries used a variety of rotavirus vaccines including vaccines that covered RV1 only, RV5 only, or both.

The researchers noted that there were some limitations to this report. They did not find any studies from high burden settings, and the data from low and medium burden settings was quite limited. And, among the studies included in their meta-analysis, researchers used a variety of methods.

In the future, CDC officials noted they hope to find information about the rotavirus vaccine's impact on those who have not been vaccinated. Most vaccines have effects that extend far beyond the vaccinated population, and this one should be no exception.

Reference

Nelson EA, Steele AD. Global Impact of Rotavirus vaccination on childhood hospitalizations and mortality from diarrhea. J Infect Dis. 2017 Apr 18. doi:10.1093/infdis/jix187. [Epub ahead of print]