Use of Rotavirus Vaccines May Save 2.5 Million Lives by 2025

Laurie Barclay, MD

April 02, 2009

April 2, 2009 — Global use of rotavirus vaccines could potentially save 2.5 million lives by 2025, according to a briefing paper released March 31 by PATH, an international nonprofit organization that helps provide appropriate health technologies by collaborating with diverse public- and private-sector partners.

"Rotavirus is one of the most deadly diseases children in the developing world face," Dr. John Wecker, PATH director of immunization solutions, said in a news release. "Vaccination holds the key to making this disease one of the most preventable. We need to stand ready to deliver vaccines to children in Africa and Asia, where most rotavirus deaths occur."

Although rotavirus vaccines are already widely used in North America, Latin America, and Europe, the disease burden is greatest in Africa and Asia, where there is limited availability of lifesaving medical care, and where these vaccines are therefore urgently needed.

Worldwide, rotavirus is responsible for the most prevalent and lethal form of diarrhea in young children, accounting for more than 2 million hospitalizations each year, as well as 500,000 deaths, of which more than 85% occur in children living in developing African and Asian countries. It is estimated that by age 3 years, every child is likely to contract rotavirus infection, regardless of their country of residence or socioeconomic status.

Symptoms of rotavirus infection include severe diarrhea, vomiting, and fever, which, if untreated, often result in severe dehydration, causing shock, cardiac arrhythmia, and death.

Rotavirus vaccination can prevent hospitalization for this infection, with an up to 80% reduction in hospitalizations and emergency department visits in the United States alone. In developing countries, improvements in water supply and sanitation help prevent other diarrheal infections but are ineffective in reducing incidence of rotavirus. Only adequate supply of vaccines can therefore help prevent deaths from rotavirus in these countries, where access to intravenous rehydration and other lifesaving medical interventions is limited.

This month the World Health Organization (WHO) will review data from a large-scale clinical rotavirus vaccine trial in Africa (Rotarix, GlaxoSmithKline) and from other rotavirus vaccine trials worldwide. On the basis of their findings, WHO will consider recommending introduction of rotavirus vaccines in all countries. Previous WHO recommendations have been to include rotavirus vaccines in national immunization programs of countries in which clinical trials showed safety and efficacy of rotavirus vaccination.

Two such large-scale clinical trials, performed in Europe, Latin America, and the United States in 2006, indicated safety and efficacy of the orally administered rotavirus vaccines Rotarix and RotaTeq (Merck and Co Inc). Findings from an African and Asian trial of RotaTeq are anticipated in fall 2009.

"Global and national leaders are ready to accelerate wider access to these lifesaving vaccines as soon as they are recommended for use in other regions of the world," Dr. Wecker said. "Preventing rotavirus-related deaths is a global health imperative."


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