Rotavirus gastroenteritis causes more than half a million deaths annually among children aged <5 years, the great majority of which occur in Africa and Asia. Vaccination is considered to be the most effective public health strategy to prevent rotavirus disease and to reduce the significant global burden of rotavirus gastroenteritis. Rotarix (GlaxoSmithKline Biologicals) is an oral, live attenuated rotavirus vaccine derived from a human G1P[8] rotavirus strain. Results of phase III studies in Europe, Latin America, and Asia have shown that Rotarix offers sustained high protection against severe rotavirus gastroenteritis during the first 2 years of life, when disease burden is highest, with broad protection demonstrated against each of the 5 main rotavirus types that circulate globally (G1, G2, G3, G4, and G9). Coupled with the availability of local burden of disease data and promising interim efficacy data from an ongoing study in Malawi and South Africa, this further reinforces the case for introduction of this rotavirus vaccine in national childhood immunization programs in Africa, where rotavirus-related mortality is significant.

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http://dx.doi.org/10.1086/653547DOI Listing

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Article Synopsis
  • The Rotarix® vaccine was introduced in Malawi's national immunization program in October 2012, and a study analyzed data on children under 5 with acute gastroenteritis from January 2012 to June 2022, comparing it to pre-vaccination data from 1997 to 2009.
  • Post-vaccine introduction, there was a significant decline in cases of rotavirus-associated gastroenteritis (RVGE), with vaccine coverage exceeding 90% by mid-2014 but dropping during the COVID-19 pandemic before rebounding.
  • The estimated overall vaccine effectiveness was modest at 36.0%, peaking in 2014 and being highest among infants at 52.5%, demonstrating the need
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Rotavirus remains a significant public health threat, especially in low-income countries, where it is the leading cause of severe acute childhood gastroenteritis, contributing to over 128,500 deaths annually. Although the introduction of the Rotarix and RotaTeq vaccines in 2006 marked a milestone in reducing mortality rates, approximately 83,158 preventable deaths persisted, showing ongoing challenges in vaccine accessibility and effectiveness. To address these issues, a novel subcutaneous vaccine formulation targeting multiple rotavirus genotypes has been developed.

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