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Link to original content: https://pubmed.ncbi.nlm.nih.gov/34590142
The Rotavirus Vaccine Story: From Discovery to the Eventual Control of Rotavirus Disease - PubMed Skip to main page content
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. 2021 Sep 30;224(12 Suppl 2):S331-S342.
doi: 10.1093/infdis/jiaa598.

The Rotavirus Vaccine Story: From Discovery to the Eventual Control of Rotavirus Disease

Roger I Glass  1   2 , Jacqueline E Tate  1 , Baoming Jiang  1 , Umesh Parashar  1
Affiliations

The Rotavirus Vaccine Story: From Discovery to the Eventual Control of Rotavirus Disease

Roger I Glass et al. J Infect Dis. .

Abstract

Worldwide, rotavirus is the leading pathogen causing severe diarrhea in children and a major cause of under 5 years mortality. In 1998, the first rotavirus vaccine, RotaShield, was licensed in the United States but a rare adverse event, intussusception, led to its withdrawal. Seven years passed before the next generation of vaccines became available, Rotarix (GSK) and Rotateq (Merck), and 11 years later, 2 additional vaccines from India, Rotavac (Bharat) and Rotasiil (Serum Institute), were recommended by World Health Organization for all children. Today, these vaccines are used in more than 100 countries and have contributed to marked decreases in hospitalizations and deaths from diarrhea. However, these live oral vaccines are less effective in low-income countries with high under 5 years mortality for reasons that are not understood. Efforts to develop new vaccines that avoid the oral route are in progress and will likely be needed to ultimately control rotavirus disease.

Keywords: child survival; childhood diarrhea; rotavirus; vaccine.

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Figures

Figure 1.
Figure 1.
Rotavirus capsid structure and dsRNA genome. A, Intact triple-layered virion with VP4 spikes projecting from the VP7 outer capsid shell. B, Cut-away of the virion revealing the 3 protein layers of the virion: VP2, VP4, and VP7. C, A VP6 hexamer, VP7 hexamer, and embedded VP4 spike with the VP8* and VP5* regions identified. D, Eleven double-stranded RNA segments of the rotavirus genome resolved by gel electrophoresis. Segments are labeled as g1–g11 (g = gene) and their protein products are listed. Associated functions or properties of the products are given (genotype name). The underlined letter identifies the segment in the gene constellation acronym: for common assignment of serotypes (genotypes), only the Gx and Px are used (eg, G1,P8). Reprinted from Patton with permission [16].
Figure 2.
Figure 2.
Countries that have introduced rotavirus vaccines into their national programs, January 2020 [54]. Colors indicate the countries being supported for introduction by the Global Alliance for Vaccines and Immunization (GAVI).
Figure 3.
Figure 3.
Effectiveness of oral rotavirus vaccines against severe rotavirus disease by country. A, Effectiveness versus per capita income. B, Effectiveness versus level of under 5 years mortality. Data by country and confidence intervals are available [58].
Figure 4.
Figure 4.
Estimated annual numbers of diarrheal and rotavirus deaths in children <5 years, from 1980 to 2017. A, Total diarrheal deaths [, 106, 108, 109, 111]. B, Rotavirus deaths [, 107, 110, 111]. Abbreviations: CDC, Centers for Disease Control and Prevention; IHME, Institute for Health Metrics and Evaluation; IOM, Institute of Medicine; K, thousand; M, million; RV, rotavirus; WHO-CHERG, World Health Organization Child Health Epidemiology Reference Group.
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