Could a rotavirus vaccine based on genotypes prevalent in India be on the horizon?

Rotavirus is a leading cause of severe infant diarrhea, causing an estimated 100,000 deaths each year in India, according to the World Health Organization. While most young children in the world contract rotavirus at some point in their early childhood, the disease course is usually much more severe for children in developing countries, including India.


“…Pediatricians should honestly inform the parents about the efficacy of the vaccine in developing countries like Bangladesh and allow the parents to make an informed choice.”
-D.K. Taneja, MD, vice president of the Indian Public Health Association and director/professor of Community Medicine at Maulana Azad Medical College in New Delhi, India


A recently published review article highlighted the burden of rotavirus in India. The authors noted that although the virus is transmitted through a feco-oral route, widespread improvements in sanitation have done little to halt its spread.

A rotavirus vaccine is available, which has been launched in 62 countries and has been added to the national immunization schedule in 11. In India, the vaccine[s2If !is_user_logged_in()]…

[/s2If][s2If is_user_logged_in()] is optional. The authors assert in their paper that the widespread adoption of the vaccine in India could save the lives of an estimated 100,000 children per year.

Key Point: Controversy exists about whether currently available rotavirus vaccines should be used in developing countries, since they were developed based on rotavirus genotypes in developed nations and may not be as efficacious in countries such as India. Physicians in India should take efficacy issues into account, and invite parents to make informed decisions about the use of these vaccines.

However, some experts say that if India were to add a rotavirus vaccine to its immunization schedule, the vaccine should be developed based on the rotavirus genotypes prevalent in India, because currently available vaccines may not be as efficacious in developing countries. For example: “The efficacy of rotavirus vaccine in Bangladesh was just about 48%, compared to about 70% to 80% in the developed countries,” D.K. Taneja, MD, said in an exclusive interview with mdCurrent-India. Taneja is vice president of the Indian Public Health Association and director/professor of Community Medicine at Maulana Azad Medical College in New Delhi, India.

Although currently available vaccines may not be ideal for developing countries, “India is conducting trials with vaccines developed indigenously with technical assistance from the U.S. National Institutes of Health,” Taneja said. “On a public health level, we need to wait for results of ongoing trials, because vaccines with low effectiveness cannot be recommended as a public health measure. In fact, till then, we would prefer to give zinc supplementation/therapy to children to prevent diarrhea.”

Taneja recommends: “On an individual level, pediatricians should honestly inform the parents about the efficacy of the vaccine in developing countries like Bangladesh and allow the parents to make an informed choice.”

Sources: Verma R, Khanna P, Chawla S. Rotavirus vaccine can save millions of children’s lives in developing countries. Hum Vaccin Immunother. 2012;8(2):272-274.

World Health Organization Web site. Diarrhoeal Diseases (updated February 2009); Available at: http://www.who.int/vaccine_research/diseases/diarrhoeal/en/index5.html.

Access the original journal information here:
http://www.landesbioscience.com/journals/vaccines/article/18390/?nocache=1932193980
Journal publishers are independent from mdCurrent-India and may require a subscription or charge a fee to download the full article.

Image: Computer assisted reconstruction of a rotavirus particle. Source: Graham Colm created this work, Author: Dr Graham Beards. 20 December 2008.
Access the original Image information here: http://en.wikipedia.org/wiki/File:Rotavirus_Reconstruction.jpg

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