ShareRotavirus vaccines | The facts
Contents
- Rotavirus vaccines offer the best hope for preventing severe rotavirus disease and the deadly dehydrating diarrhea that it causes
- Two safe and effective rotavirus vaccines are saving lives today
- WHO recommends that rotavirus vaccines be introduced into every country’s national immunization program
- Global and GAVI-eligible rotavirus vaccine introductions
- Rotavirus vaccines are saving lives and improving health in countries where children have access to them
- Impact of rotavirus vaccines | Tables
- Rotavirus vaccines are cost-effective and a wise investment
- The power of rotavirus vaccines to prevent childhood deaths and hospitalizations
Rotavirus vaccines offer the best hope for preventing severe rotavirus disease and the deadly dehydrating diarrhea that it causes
GAVI/Ryan Youngblood
Vaccines are the best way to protect children from rotavirus and the deadly dehydrating diarrhea that it causes. Rotavirus cannot be treated with antibiotics or other drugs. While diarrhea caused by many bacteria and parasites can be stopped by improving hygiene, water quality, and sanitation, these improvements do not adequately prevent the spread of rotavirus. Mild rotavirus infections can be treated effectively in the same manner as other forms of diarrhea, by providing fluids and salts (oral rehydration therapy) until the disease runs its course. However, children with severe rotavirus diarrhea urgently need intravenous fluids, or they risk dying from dehydration. In developing countries, this type of urgent medical care is often inaccessible or unavailable, making rotavirus prevention through vaccination critical to saving children’s lives.
Research suggests that rotavirus vaccines are most effective at preventing the most severe and life-threatening cases of rotavirus. A small proportion of vaccinated infants may develop rotavirus disease more than once because neither the vaccine nor natural infection provides full immunity (protection) from future infections, and there are many different types of rotavirus. Usually a person’s first infection with rotavirus causes the most severe symptoms.
Rotavirus resources
- Rotavirus Disease and Vaccines FAQs | French
- GAVI’s Global Rotavirus Disease and Vaccines fact sheet | French
- PATH’s Rotavirus Disease and Vaccines in Africa fact sheet | French
- PATH’s Rotavirus Disease and Vaccines in Asia fact sheet
- PATH’s Rotavirus Diease and Vaccines country-specific
Two safe and effective rotavirus vaccines are saving lives today
There are two rotavirus vaccines available today: Rotarix®, manufactured by GlaxoSmithKline, and RotaTeq®, manufactured by Merck & Co. Inc. Both rotavirus vaccines are given orally but differ in the number of doses given. Each country has its own immunization schedule. In general, in lower income countries, RotaTeq® is given in three doses at 6 weeks, 10 weeks, and 14 weeks of age, and Rotarix® is given in two doses at 10 weeks and 14 weeks of age. In middle- and upper-income countries, RotaTeq® is given in three doses at 2 months, 4 months, and 6 months of age, and Rotarix® is given in two doses at 2 months and 4 months of age. Both vaccines have been shown to be safe and effective in large-scale clinical trials in Africa, Asia, Europe, Latin America, and the US.
Clinical studies have shown that rotavirus vaccine efficacy against severe rotavirus during the first year of life has ranged from 85 to 98 percent in industrialized countries, including in Latin America, and 51 to 64 percent in developing countries in Africa and Asia. On the basis of efficacy data from Europe and America, the WHO initially approved use of the vaccines in these regions in 2006. Subsequently, after proof of efficacy in Asia and Africa, the WHO recommended that rotavirus vaccines be introduced into every country’s national immunization program, particularly in countries where diarrheal disease is a major health problem.
Although in some clinical trials lower vaccine efficacy was observed in certain low-income countries compared with data from middle- and high-income countries, rotavirus vaccines are expected to have a major public health impact in where the rotavirus burden is greatest—such as in developing countries in Africa and Asia. Efficacy is only one factor in assessing the potential impact of a vaccine; the other critical factor is the incidence of severe disease. The vaccine likely will have a greater impact than we have seen elsewhere, even at a lower efficacy rate, because rotavirus vaccines will still substantially reduce severe cases of rotavirus diarrhea—those that are most life threatening.
Lower efficacy of oral vaccines is typical in countries with high rates of poverty and death. This is seen with other orally administered vaccines like polio, cholera, and typhoid. Several factors may contribute to lower efficacy, such as the age of the child when the vaccine is administered, possible interference by maternal antibodies, micronutrient deficiencies, persistent exposure to pathogens, higher prevalence of co-infections, or wide varieties of virus strains. The Accelerated Vaccine Introduction Initiative Technical Assistance Consortium, PATH, and others are studying these factors so that national health ministries will ultimately be able to optimize rotavirus vaccination strategies and provide children the best possible protection.
WHO recommends that rotavirus vaccines be introduced into every country’s national immunization program, particularly in countries where diarrheal disease is a major health problem
As of April 27, 2013, 45 countries—mostly middle-and high-income countries—have introduced rotavirus vaccines in their national immunization programs (i.e., the public sector). Other countries, such as Canada, Thailand, and Zambia have introduced rotavirus vaccines in pilot or regional introductions. Routine, public-sector use of rotavirus vaccines in low-income, GAVI-eligible countries is limited but expanding. Rotavirus vaccines are also available in more than 100 countries through the private market.
Rotavirus Vaccine Introductions: Worldwide
Figure 1. National introductions of rotavirus vaccines: 45 countries.
Download the Rotavirus vaccine introductions: Worldwide map slide set [PPT 1.3 MB] containing:
- Full-sized map with country listings by WHO region.
- Full-sized map with country listings by geographic region.
- Full-sized map without country listings.
English [PPT 1.3 MB] | French [PPT 1.6 MB]
Rotavirus Vaccine Introductions: GAVI-supported
By 2015, GAVI and its partners plan to support at least 40 countries in introducing rotavirus vaccines—immunizing more than 50 million children. GAVI began offering support for rotavirus vaccines in 2006. Since then, rotavirus vaccines have been introduced in Nicaragua (2006), Bolivia (2008), Honduras (2009), Guyana (2010), Sudan (2011), Ghana (2012), Rwanda (2012), Moldova (2012), Yemen (2012), Armenia (2012), Malawi (2012), Tanzania (2012), Georgia (2013), and Haiti (2013) with GAVI support. GAVI has approved 20 additional countries for rotavirus vaccine support including: Angola, Burkina Faso, Burundi, Cameroon, Central Africa Republic, Republic of the Congo, Djibouti, Eritrea, Ethiopia, Gambia, Guinea-Bissau, Kenya, Madagascar, Mali, Niger, Sierra Leone, Togo, Uzbekistan, Zambia, and Zimbabwe.
Figure 2. GAVI-supported introductions of rotavirus vaccines: 14 countries.
Download the Rotavirus vaccine introductions: GAVI-supported map slide set containing:
- Full-sized map with country listings by WHO region.
- Full-sized map with country listings by geographic region.
- Full-sized map without country listings.
English [PPT 306 KB] | French [PPT 284 KB]
Complete country rotavirus introduction list
Country introduction interactive spreadsheet | 45 countries around the world have introduced rotavirus vaccines through their national immunization programs, including 14 GAVI-eligible countries. This interactive rotavirus introduction spreadsheet provides a WHO-validated list of all countries using rotavirus vaccines in their national immunization programs, with sorting and filtering by WHO region, World Bank classification, GAVI eligibility, and vaccine product. This spreadsheet is updated regularly.
Download this file in Excel (searchable) [67 KB]: English | French [67 KB]
Download this file as a PDF [89 KB]: English | French [90 KB]
Rotavirus vaccines are saving lives and improving health in countries where children have access to them
Swift and significant declines in hospitalization and deaths due to rotavirus and all-cause diarrhea have been observed in many of the countries that have introduced rotavirus vaccines into their national immunization programs. Researchers also have found that use of rotavirus vaccines may protect unvaccinated children and adults by reducing transmission (an effect called herd immunity).
Rotavirus vaccines are key to a comprehensive approach to reduce the impact of diarrheal disease. Introducing rotavirus vaccines with other diarrhea prevention and treatment methods, such as oral rehydration therapy, zinc supplementation, breastfeeding, improved hygiene, water quality, sanitation, and nutrition, can significantly reduce child illnesses and deaths.
Impact of rotavirus vaccines | Tables
Download a complete set of the impact tables: English | French
Table 1. Impact of rotavirus vaccines on hospitalizations for rotavirus gastroenteritis among children <5 years old.
2Yen C, Tate JE, Wenk JD, Harris JM 2nd, Parashar UD. Diarrhea-associated hospitalizations among US children over 2 rotavirus seasons after vaccine introduction. Pediatrics. 2011;127:e9–e15.
3Tate JE, Mutuc JD, Panozzo CA, et al. Sustained decline in rotavirus detections in the United States following the introduction of rotavirus vaccine in 2006. Pediatric Infectious Disease Journal. 2011;30(suppl 1):S30–S34.
4Buttery JP, Lambert SB, Grimwood K, et al. Reduction in rotavirus-associated acute gastroenteritis following introduction of rotavirus vaccine into Australia’s National Childhood vaccine schedule. Pediatric Infectious Disease Journal. 2011;30(suppl 1):S25–S29.
5Braeckman T, Van Herck K, Raes M, Vergison A, Sabbe M, Van Damme P. Rotavirus vaccines in Belgium: Policy and impact. Pediatric Infectious Disease Journal. 2011;30(suppl 1):S21–S24.
6Raes M, Strens D, Vergison A, Verghote M, Standaert B. Reduction in pediatric rotavirus-related hospitalizations after universal rotavirus vaccination in Belgium. Pediatric Infectious Disease Journal. 2011;30: e120–e25.
7Paulke-Korinek M, Rendi-Wagner P, Kundi M, Kronik R,Kollaritsch H. Universal mass vaccination against rotavirus gastroenteritis: impact on hospitalization rates in Austrian children. Pediatric Infectious Disease Journal. 2010;29:319–323.
8Paulke-Korinek M, Kundi M, Rendi-Wagner P, et al. Herd immunity after two years of the universal mass vaccination program against rotavirus gastroenteritis in Austria. Vaccine. 2011;29:2791–2796.
Table 2. Impact of rotavirus vaccines on hospitalizations for all-cause acute gastroenteritis among children <5 years old.
2Cortese MM, Tate JE, Simonsen L, Edelman L, Parashar UD. Reduction in gastroenteritis in United States children and correlation with early rotavirus vaccine uptake from national medical claims databases. Pediatric Infectious Disease Journal. 2010;29:489–494.
3Yen C, Tate JE, Wenk JD, Harris JM 2nd, Parashar UD. Diarrhea-associated hospitalizations among US children over 2 rotavirus seasons after vaccine introduction. Pediatrics. 2011;127:e9–e15.
4Raes M, Strens D, Vergison A, Verghote M, Standaert B. Reduction in pediatric rotavirus-related hospitalizations after universal rotavirus vaccination in Belgium. Pediatric Infectious Disease Journal. 2011;30: e120–e25.
5Lanzieri TM, Costa I, Shafi FA, et al. Trends in hospitalizations from all-cause gastroenteritis in children younger than 5 years of age in Brazil before and after human rotavirus vaccine introduction, 1998–2007. Pediatric Infectious Disease Journal. 2010;29:673–675.
6do Carmo GM, Yen C, Cortes J, Siqueira AA, de Oliveira WK, Cortez-Escalante JJ, et al. Decline in diarrhea mortality and admissions after routine childhood rotavirus immunization in Brazil: a time-series analysis. PLoS Medicine. 2011;8(4):e1001024.
7Quintanar-Solares M, Yen C, Richardson V, Esparza-Aguilar M, Parashar UD, Patel MM. Impact of rotavirus vaccination on diarrhea-related hospitalizations among children <5 years of age in Mexico. Pediatric Infectious Disease Jounal. 2011;30(suppl 1):S11–S15.
8Yen C, Armero Guardado JA, Alberto P, et al. Decline in rotavirus hospitalizations and health care visits for childhood diarrhea following rotavirus vaccination in El Salvador. Pediatric Infectious Disease Journal. 2011;30 (suppl 1):S6–S10.
Table 3. Impact of rotavirus vaccines on deaths for all-cause acute gastroenteritis among children <5 years old.
2do Carmo GM, Yen C, Cortes J, Siqueira AA, de Oliveira WK, Cortez-Escalante JJ, et al. Decline in diarrhea mortality and admissions after routine childhood rotavirus immunization in Brazil: A time-series analysis. PLoS Medicine. 2011;8(4):e1001024.
3Richardson V, Hernandez-Pichardo J, Quintanar-Solares M, Esparza-Aguilar M, Johnson B, Gomez-Altamirano CM, et al. Effect of rotavirus vaccination on death from childhood diarrhea in Mexico. The New England Journal of Medicine. 2010;362(4):299–305.
4Richardson V, Parashar U, Patel M. Childhood diarrhea deaths after rotavirus vaccination in Mexico. The New England Journal of Medicine. 2011;365(8):772–773.
Table 4. Indirect benefits of rotavirus vaccination (“herd immunity”).
2Yen C, Tate JE, Wenk JD, Harris JM 2nd, Parashar UD. Diarrhea-associated hospitalizations among US children over 2 rotavirus seasons after vaccine introduction. Pediatrics. 2011;127:e9–e15.
3Field EJ, Vally H, Grimwood K, Lambert SB. Pentavalent rotavirus vaccine and prevention of gastroenteritis hospitalizations in Australia. Pediatrics. 2010;126:e506–512.
4Raes M, Strens D, Vergison A, Verghote M, Standaert B. Reduction in pediatric rotavirus-related hospitalizations after universal rotavirus vaccination in Belgium. Pediatric Infectious Disease Journal. 2011;30: e120–e25.
5Paulke-Korinek M, Kundi M, Rendi-Wagner P, et al. Herd immunity after two years of the universal mass vaccination program against rotavirus gastroenteritis in Austria. Vaccine. 2011;29:2791–2796.
6Safadi MA, Berezin EN, Munford V, et al. Hospital-based surveillance to evaluate the impact of rotavirus vaccination in São Paulo, Brazil. Pediatric Infectious Disease Journal. 2010;29:1019–1022.
7Yen C, Armero Guardado JA, Alberto P, et al. Decline in rotavirus hospitalizations and health care visits for childhood diarrhea following rotavirus vaccination in El Salvador. Pediatric Infectious Disease Journal. 2011;30 (suppl 1):S6–S10.
Rotavirus vaccines are cost-effective and a wise investment
Rotavirus vaccines are cost-effective and not only improve child health, but they also save lives. If used in all GAVI-eligible countries, rotavirus vaccines could prevent an estimated 180,000 deaths and avert 6 million clinic and hospital visits each year, thereby saving US$68 million annually in treatment costs.
Rotavirus vaccines are an essential and lifesaving intervention in comprehensive diarrhea-control strategies. Adding rotavirus vaccines to national immunization programs and integrating them with appropriate diarrheal disease control interventions as part of a package of strategies to prevent diarrheal disease-related deaths will facilitate achievement of Millennium Development Goal 4—reduction of child mortality.
Accelerating access to rotavirus vaccines by GAVI and its partners will not only save children’s lives but also lessen the tremendous economic and health burden of rotavirus disease, thereby contributing to poverty reduction and a growing economy.
The power of rotavirus vaccines to prevent childhood deaths and hospitalizations highlights the importance of providing accelerated access to these vaccines to children around the world.
GAVI/2012/OlivierAsselin
GAVI is the key to increasing access to rotavirus vaccines and saving children’s lives. In GAVI-eligible countries, where 95 percent of deaths due to rotavirus occur, more than 2.4 million child deaths can be prevented by 2030 by accelerating access to lifesaving rotavirus vaccines. GAVI and its partners plan to support the introduction of rotavirus vaccines in at least 40 of the world’s poorest countries by 2015, immunizing more than 50 million children. Policymakers, donors, and the global health community must work together to help overcome the challenges to getting rotavirus vaccines and other diarrheal disease interventions to all children worldwide.