Vaccinare
La vaccinazione contro il Rotavirus
ROTAVIRUS VACCINE
GABRIELLA PALLA, ALESSANDRO VENTURA
Istituto di Clinica Pediatrica, Università di Pisa
Gennaio 1997 - pagg. 29 -33
Abstract
Rotavirus is the leading cause of severe
diarrhoea in infants and causes an estimated
900.000 deaths annually in developing
countries. In developed cauntries the rate of
hospital admission for Rotavirus gastroenteritis
is 3-10/1000 childrens aged less than
5 years, with an estimated 150 deaths annually
in USA. Several live oral Rotavirus
vaccine have been evaluated in large field
trials. First generation vaccines, derived
from animal strains (bovine WC3,
RIT4237, Rhesus MMU18006) showed a
variable protective effect with particularly
low efficacy in developing countries. The
vaccines derived from human attenuated
strains (M37 nursery), have not been sufficientily
evaluated in fields trials and do not
seem to give an eterotypic protection. Polyvalent
vaccines, reassorted from human
and animal attenuated strains show a good
protective effect (about 70%), particularly if
given in three doses. It has been calculated
that in USA an active vaccination programme
would allow to save about 80 millions
dollars/year in health expenditure and
450 millions dollars in related social costs.
Rotavirus vaccination may not represent an
absolute priority in comparison to other public
health interventions. A cost/benefit
evaluation must be made taking into account
the health resources and priorities of
each specific country.
Classificazione MeSH
Bibliografia
1. Conner ME, Matson DO, Estes MK: Rotavirus
vaccine and vaccination potential. Current
Topics in Microbiology and Immunology
185, 286-317, 1994.
2. Haffejee IE: The epidemiology of Rotavirus infection: a global perspective. J Pediatr Gastroenterol Nutr 20, 275-283, 1995.
3. Blacklow NR, Greenberg HB: Viral gastroenteritis. N Engl J Med 325, 252-264, 1991.
4. Villirillo A, Palla G, Ughi C, Maggiore G, Ventura A: La diarrea acuta come causa di ricovero. Medico e Bambino 6, 302-307, 1995.
5. Haffejee IE: The status of Rotavirus vaccines in 1990. J Infect 22, 119-128, 1991.
6. De Mol P, Zissis G, Butzler JP, Mutwewingabo A, Andrè FE: Failure of live attenuated oral Rotavirus vaccine. Lancet ii, 108, 1986.
7. Hanlon P, Hanlon L, Marsch V, Byass P, Shenton F et al: Trial of an attenuated bovine Rotavirus vaccine ( RIT 4237) in gambian infants. Lancet i, 1342-1345, 1987.
8. Clark HF, Borian FE, Bell LM, Modesto K, GouvcaV et al: Protective effect of WC3 vaccine against Rotavirus diarrhea in infants during a predominantly serotype 1 Rotavirus season. J Infect Dis 158, 570-586, 1988.
9. Bernstein DI, Smith VC, Sander DS et al: Evaluation of WC3 Rotavirus vaccine and correlation of protection in healthy infants. J Infect Dis 162, 1055-1062, 1990.
10. Georges-Courbot MC, Monges J, Siopathis MR, Roungou JB, Gresenguet G et al: Evaluation of the efficacy of a low-passage Rotavirus (strain WC3) vaccine in children in Central Africa. Res Virol 142, 405-411, 1991.
11. Ward RL, Sander DS, Schiff GM, Bernstein DI: Effect of vaccination on serotypespecific antibody in infants administred WC3 bovine Rotavirusvaccine before and after a natural Rotavirus infection. J Infest Dis 162, 1288-1303, 1990.
12. Flores J, Perez-Schael I, Gonzales M, Garcia D, Perez M et al: Protection against severe Rotavirus diarrhea by Rhesus Rotavirus vaccine in venezuelanchildren. Lancet i, 882-884, 1987.
13. Vesikari T, Rautanen T, Varis T, Beardes GM, Kapikian AZ: Rhesus Rotavirus candidate vaccine. Clinical trial in children vaccinated between 2 and 5 months of age. AJDC 144, 285-289, 1990.
14. Vesikari T,Ruuska T, Koivu HP, Green KY, Flores J, Kapikian AZ: Evaluation of the M 37 human Rotavirus vaccine in 2 to 6 months old infants. Pediatr Infect Dis J 10, 912-917, 1991.
15. Flores J, Peres-Schael I, Blanc M, White L, Garcia D et al: Comparison of reactogenicity and antigenicity of M 37 Rotavirus vaccine and Rhesus Rotavirus based quadrivalent vaccine. Lancet 336, 330-333, 1990.
16. Perez-Schael I, Blanco M, Vilar M, Garcia D, White L et al: Clinical studies of a quadrivalent Rotavirus vaccine in venezuelan infants. J Clin Microbiol 28, 553-558, 1990.
17. Ceyhan M, Kanza G, Secumeer G, Midthun K et al: Take of rhesus-human reassortant tetravalent Rotavirus vaccine in brestfed infants. Acta Pediatr 82, 223-227, 1993.
18. Rennels MB, Wasserman SS, Class RI, Keane VA: Comparison of immunogenicity and efficacy of Rhesus Rotavirus reassortant vaccines in breastfed and non breastfed children. Pediatrics 96, 1132-1136, 1995. 19.Rennels MB, Glass RI, Dennelly PH, Bernstein DI et al: Safety and efficacy of high dose Rhesus Human Reassortant vaccines. Report of the National multicenter trial. Pediatrics 97, 7-13, 1996.
20. Clark HF, Borian FE, Plotkin SA: Immune protection of infants against Rotavirus gastroenteritis by a serotype 1 reassortant of bovine Rotavirus WC3. J Infec. Dis 161, 1099- 1104, 1990.
21. Glass RI, Gentsch JR, Ivanoff B: New lessons for Rotavirus vaccines. Science 272, 46- 48, 1996.
22. Vesikari T, Ruoka T, Green KY, Flores J, Kapikian AZ: Protective efficacy against serotype 1 rotavirus diarrhea by live oral Rhesus- human reassortant Rotavirus vaccines with human Rotavirus VP7 serotype 1 or 2 specificity. Pediatr Infect Dis J 11, 535-542, 1992.
23. Ball JM, Tian P, Zeng CQY, Morris AP, Eastes MK: Age dependent diarrhea induced by a rotaviral non struttural glycoprotein. Science 272, 101-104, 1996.
24. Smith JC, Haddix AC, Tentsch ST, Glass RI: Cost- effectiveness analysis of Rotavirus Immunization Program for the United States. Pediatrics 96, 609-615, 1995.
2. Haffejee IE: The epidemiology of Rotavirus infection: a global perspective. J Pediatr Gastroenterol Nutr 20, 275-283, 1995.
3. Blacklow NR, Greenberg HB: Viral gastroenteritis. N Engl J Med 325, 252-264, 1991.
4. Villirillo A, Palla G, Ughi C, Maggiore G, Ventura A: La diarrea acuta come causa di ricovero. Medico e Bambino 6, 302-307, 1995.
5. Haffejee IE: The status of Rotavirus vaccines in 1990. J Infect 22, 119-128, 1991.
6. De Mol P, Zissis G, Butzler JP, Mutwewingabo A, Andrè FE: Failure of live attenuated oral Rotavirus vaccine. Lancet ii, 108, 1986.
7. Hanlon P, Hanlon L, Marsch V, Byass P, Shenton F et al: Trial of an attenuated bovine Rotavirus vaccine ( RIT 4237) in gambian infants. Lancet i, 1342-1345, 1987.
8. Clark HF, Borian FE, Bell LM, Modesto K, GouvcaV et al: Protective effect of WC3 vaccine against Rotavirus diarrhea in infants during a predominantly serotype 1 Rotavirus season. J Infect Dis 158, 570-586, 1988.
9. Bernstein DI, Smith VC, Sander DS et al: Evaluation of WC3 Rotavirus vaccine and correlation of protection in healthy infants. J Infect Dis 162, 1055-1062, 1990.
10. Georges-Courbot MC, Monges J, Siopathis MR, Roungou JB, Gresenguet G et al: Evaluation of the efficacy of a low-passage Rotavirus (strain WC3) vaccine in children in Central Africa. Res Virol 142, 405-411, 1991.
11. Ward RL, Sander DS, Schiff GM, Bernstein DI: Effect of vaccination on serotypespecific antibody in infants administred WC3 bovine Rotavirusvaccine before and after a natural Rotavirus infection. J Infest Dis 162, 1288-1303, 1990.
12. Flores J, Perez-Schael I, Gonzales M, Garcia D, Perez M et al: Protection against severe Rotavirus diarrhea by Rhesus Rotavirus vaccine in venezuelanchildren. Lancet i, 882-884, 1987.
13. Vesikari T, Rautanen T, Varis T, Beardes GM, Kapikian AZ: Rhesus Rotavirus candidate vaccine. Clinical trial in children vaccinated between 2 and 5 months of age. AJDC 144, 285-289, 1990.
14. Vesikari T,Ruuska T, Koivu HP, Green KY, Flores J, Kapikian AZ: Evaluation of the M 37 human Rotavirus vaccine in 2 to 6 months old infants. Pediatr Infect Dis J 10, 912-917, 1991.
15. Flores J, Peres-Schael I, Blanc M, White L, Garcia D et al: Comparison of reactogenicity and antigenicity of M 37 Rotavirus vaccine and Rhesus Rotavirus based quadrivalent vaccine. Lancet 336, 330-333, 1990.
16. Perez-Schael I, Blanco M, Vilar M, Garcia D, White L et al: Clinical studies of a quadrivalent Rotavirus vaccine in venezuelan infants. J Clin Microbiol 28, 553-558, 1990.
17. Ceyhan M, Kanza G, Secumeer G, Midthun K et al: Take of rhesus-human reassortant tetravalent Rotavirus vaccine in brestfed infants. Acta Pediatr 82, 223-227, 1993.
18. Rennels MB, Wasserman SS, Class RI, Keane VA: Comparison of immunogenicity and efficacy of Rhesus Rotavirus reassortant vaccines in breastfed and non breastfed children. Pediatrics 96, 1132-1136, 1995. 19.Rennels MB, Glass RI, Dennelly PH, Bernstein DI et al: Safety and efficacy of high dose Rhesus Human Reassortant vaccines. Report of the National multicenter trial. Pediatrics 97, 7-13, 1996.
20. Clark HF, Borian FE, Plotkin SA: Immune protection of infants against Rotavirus gastroenteritis by a serotype 1 reassortant of bovine Rotavirus WC3. J Infec. Dis 161, 1099- 1104, 1990.
21. Glass RI, Gentsch JR, Ivanoff B: New lessons for Rotavirus vaccines. Science 272, 46- 48, 1996.
22. Vesikari T, Ruoka T, Green KY, Flores J, Kapikian AZ: Protective efficacy against serotype 1 rotavirus diarrhea by live oral Rhesus- human reassortant Rotavirus vaccines with human Rotavirus VP7 serotype 1 or 2 specificity. Pediatr Infect Dis J 11, 535-542, 1992.
23. Ball JM, Tian P, Zeng CQY, Morris AP, Eastes MK: Age dependent diarrhea induced by a rotaviral non struttural glycoprotein. Science 272, 101-104, 1996.
24. Smith JC, Haddix AC, Tentsch ST, Glass RI: Cost- effectiveness analysis of Rotavirus Immunization Program for the United States. Pediatrics 96, 609-615, 1995.