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Rotavirus vaccination: a concise review [Article de Revue]

[Vaccination contre les rotavirus : revue]
Vesikari, T
Clinical microbiology and infection. 2012/10; 18(Supplement 5) : 57-63
Summary: Live attenuated oral rotavirus vaccines were tested for proof-of concept in the early 1980's, the first vaccine (RotaShield., Wyeth) was introduced in 1998 but subsequently withdrawn because of association with intussusception (IS), and the two currently licensed vaccine (Rotarix., GlaxoSmithKline, and RotaTeq., Merck) were introduced in 2006. Before licensure both vaccines were extensively tested for safety (for IS) and efficacy in trials comprising of over 60.000 infants each. Rotarix. is a single strain human rotavirus vaccine (RV1) and RotaTeq. is a combination of 5 bovine-human reassortant rotaviruses (RV5). While the composition of the two vaccines is different, their field effectiveness and, largely, mechanism of action are similar. Both prevent effectively severe rotavirus gastroenteritis (RVGE) but are less efficacious against mild RVGE or rotavirus infection. Field effectiveness of these vaccines in Europe and the USA against severe RVGE has been above 90% and in Latin America around 80%. Trials in Africa have yielded efficacy rates between 50 and 80%. Rotavirus vaccination has been introduced into national immunization programmes of about 20 countries in Latin America, with Brazil and Mexico as leading countries, as well as the USA, Australia, and South Africa. Introduction into Africa will start in 2012. In Europe, Belgium, Luxembourg, Austria and Finland and 5 federal states of Germany have introduced universal rotavirus vaccination. The reasons for the slow progress in Europe include low mortality from RVGE, unfavourable cost-benefit calculations in some countries, and concerns that still exist over IS.



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Clinical microbiology and infection

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