Current and new rotavirus vaccines

Abstract

Purpose of review: As of 2019, four rotavirus vaccines have been prequalified by the WHO for use worldwide. This review highlights current knowledge regarding rotavirus vaccines available, and provides a brief summary of the rotavirus vaccine pipeline.

Recent findings: Data generated from use of currently available products supports their effectiveness and impact in diverse settings. Rotavirus vaccines have a favorable risk-benefit profile, but previous associations of rotavirus vaccination with intussusception necessitate continued monitoring for this rare but serious adverse event. Implementation of rotavirus vaccines was jeopardized in late 2018 and 2019 by a shortage of vaccine supply. Fortunately, with the prequalification of two additional vaccines in 2018, countries have increased choice in products with different characteristics, pricing, and implementation strategies. Other vaccines currently in development may open up further immunization strategies, such as neonatal vaccination schedules or parenteral administration.

Summary: Rotavirus vaccines have demonstrated impact in reducing diarrheal morbidity and mortality worldwide. As countries begin to introduce the newly prequalified vaccines, additional data will become available on the safety and effectiveness of those products. Products in the pipeline have distinct profiles and could be an essential part of the expansion of rotavirus vaccine use worldwide.

Box 1

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FIGURE 1

Map of rotavirus vaccine introduction worldwide. The status of rotavirus vaccine introduction is indicated by color, with dark green for universal (national) introduction, and light green for introduction on a phased or regional basis. Countries that have not introduced rotavirus vaccine into their national immunization schedules are shown in gray; rotavirus vaccine may be available via the private market in some countries.

FIGURE 2

Rotavirus vaccine products in active development. Rotavirus vaccine products are shown by stage of development (horizontal position corresponding to labeled chevrons) and type (color). Oral vaccines are shown in green, whereas parenterally administered vaccines are shown in orange. Dashed lines indicate completely new products under development, whereas solid lines indicate licensed products pursuing new formulatons.