Real World Impact of Rotavirus Vaccination

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The real world impact of rotavirus vaccination is summarized in the January 2011 special supplement to The Pediatric Infectious Disease Journal, “Real World Impact of Rotavirus Vaccination.” Study findings published in the supplement demonstrate the substantial impact of rotavirus vaccines on the health of children in developed and developing countries that have introduced the vaccines.

Rotavirus causes gastroenteritis (inflammation of the stomach and intestines). Symptoms include severe watery diarrhea, often with vomiting, fever, and abdominal pain. Due to the dehydration (loss of body fluids) that can result, rotavirus is responsible for approximately half a million deaths worldwide each year in children younger than 5 years of age. Developing countries are particularly at risk.

Two effective rotavirus vaccines, a single-strain attenuated human rotavirus vaccine (Rotarix, GlaxoSmithKline Biologicals) and a multistrain bovine-human reassortant vaccine (RotaTeq, Merck and Company), are now available and recommended for routine immunization of all infants by the World Health Organization (WHO).

Dr. Anne Schuchat, director, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention (CDC), states “These studies add to the growing body of evidence that shows rotavirus vaccines are safe, effective, and most importantly, saving children’s lives. Unfortunately, too many children around the world get severely ill or die from this preventable disease. We must continue to expand our efforts to ensure that children around the world have access to these vaccines.”

After the vaccine was introduced in the United States in July 2006, there was a 58 to 86% reduction in rotavirus-related hospitalizations over following three years.

Mexico has noted a 40% decrease in diarrhea-related hospitalizations in children under 5 years of age in 2009 during rotavirus season after introducing the vaccine in May 2007.

El Salvador introduced the rotavirus vaccine in October 2006. They have seen a reduction of 69-81% in rotavirus hospitalizations for children under 5 years of age.

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Australia introduced the rotavirus vaccine in July 2007. They have seen a striking 89-94% reduction in rotavirus-related hospitalizations in children under five years of age living in Queensland in the two years following vaccine introduction.

The studies also show that there have been large reductions in rotavirus disease among older, unvaccinated children, suggesting that vaccination may limit the overall amount of virus transmission, thereby indirectly protecting the larger population. This phenomenon, known as “herd immunity,” will require continued study.

“Rotavirus vaccines have enormous potential to save lives, and it is tragic that they are not more widely available to the children who need them most,” said Helen Evans, interim chief executive officer of the GAVI Alliance. “We urgently need to get these life-saving vaccines to children in developing countries.”

GAVI has committed to supporting rotavirus vaccine introduction in at least 40 of the world’s poorest countries by 2015. The Alliance is seeking approximately US $4 billion from donors to fund the purchase of the vaccines and for other life-saving interventions.

“Wherever we look, in both the developed and developing worlds, we see a rapid and impressive reduction in rotavirus infections following the roll-out of vaccine,” said Dr. John Wecker, director of the Vaccine Access and Delivery Global Program, PATH. “Vaccine effectiveness often takes years to document; with rotavirus, there is an immediate dramatic impact—one which should compel decision-makers and donors to support and implement the WHO recommendation to introduce rotavirus vaccines today.”

Sources
Real-world Impact of Rotavirus Vaccination; Patel, Manish M.; Steele, Duncan; Gentsch, Jon R.; Wecker, John; Glass, Roger I.; Parashar, Umesh D.; Pediatric Infectious Disease Journal. 30(1):S1-S5, January 2011; doi: 10.1097/INF.0b013e3181fefa1f

Global Alliance for Vaccines and Immunization

Centers for Disease Control and Prevention

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