Rotavirus vaccine efficacy: current status and areas for improvement

Abstract

The difference noted in Rotavirus vaccine efficiency between high and low income countries correlates with the lack of universal access to clean water and higher standards of hygiene. Overcoming these obstacles will require great investment and also time, therefore more effective vaccines should be developed to meet the needs of those who would benefit the most from them. Increasing our current knowledge of mucosal immunity, response to Rotavirus infection and its modulation by circadian rhythms could point at actionable pathways to improve vaccination efficacy, especially in the case of individuals affected by environmental enteropathy. Also, a better understanding and validation of Rotavirus entry factors as well as the systematic monitoring of dominant strains could assist in tailoring vaccines to individual's needs. Another aspect that could improve vaccine efficiency is targeting to M cells, for which new ligands could potentially be sought. Finally, alternative mucosal adjuvants and vaccine expression, storage and delivery systems could have a positive impact in the outcome of Rotavirus vaccination.

Risk of intussusception after monovalent rotavirus vaccine (Rotavac) in Indian infants: A self-controlled case series analysis

“…Lower efficacy (49.7–64.5%) in clinical trials and effectiveness (18–69%) of the RVVs have been observed in LMICs from Africa, Latin America and Asia compared to the middle and high income countries [40] , [5] . The lower immune responses to the RVVs may be due to lower replication of the RVV viruses in the intestine of infants in LMICs, which is reflected in lower fecal shedding [33] .…”

Roles of bile acids in enteric virus replication

“…Rotavirus is the leading cause of severe gastroenteritis in children less than 5 years of age (Crawford et al 2017) and also a common cause of diarrhea in young animals (Doro et al 2015). Although effective live-attenuated vaccines are available for human rotavirus infection (Carvalho and Gill 2019), rotavirus still remains the most important cause of gastroenteritis in infants and children worldwide. Kim and Chang demonstrated that CDCA and DCA significantly reduced rotavirus replication in cell culture in a dose-dependent manner with activation of FXR/small heterodimer partner signaling pathway.…”

For Whom the Clock Ticks: Clinical Chronobiology for Infectious Diseases

“…The vaccination of mice with DCs loaded with antigen leads to the expansion of specific CD8 + T cells and a better efficiency for a bacterial challenge if the vaccination is done in the middle of the day as compared with other time points. This response is abrogated when the Bmal1 gene is invalidated in DCs ( 142 ) Even if these results are promising, confirmation in other types of vaccination remains required.…”