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Review
. 2021 Apr 26;10(5):520.
doi: 10.3390/pathogens10050520.

The Rotavirus Vaccine Landscape, an Update

Roberto Cárcamo-Calvo  1 , Carlos Muñoz  1 , Javier Buesa  1   2 , Jesús Rodríguez-Díaz  1   2 , Roberto Gozalbo-Rovira  1   2
Affiliations
Review

The Rotavirus Vaccine Landscape, an Update

Roberto Cárcamo-Calvo et al. Pathogens. .

Abstract

Rotavirus is the leading cause of severe acute childhood gastroenteritis, responsible for more than 128,500 deaths per year, mainly in low-income countries. Although the mortality rate has dropped significantly since the introduction of the first vaccines around 2006, an estimated 83,158 deaths are still preventable. The two main vaccines currently deployed, Rotarix and RotaTeq, both live oral vaccines, have been shown to be less effective in developing countries. In addition, they have been associated with a slight risk of intussusception, and the need for cold chain maintenance limits the accessibility of these vaccines to certain areas, leaving 65% of children worldwide unvaccinated and therefore unprotected. Against this backdrop, here we review the main vaccines under development and the state of the art on potential alternatives.

Keywords: diarrhea; gastroenteritis; intussusception; rotavirus; vaccine.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Biosynthesis route of HBGAs. These are synthesized by sequential addition of a monosaccharide to the terminal disaccharide of the precursor glycan. The figure shows the synthesis pathways starting from type 1 and 2 precursors. The glycosidic bonds are separated by a diagonal bar to specify the pathways of the different chains. The fucosyltransferases FUT2 and FUT3 drive the biosynthesis of the secretory (Se) and Lewis (Le) antigens, respectively, by catalyzing the specific addition of α-fucose residues. Enzymes A and B catalyze the specific addition of N-acetylgalactosamine and galactose respectively. Additions of glycans by enzymes A, B and FUT2 to the precursor galactose residue result in ABH HBGA. The addition of α-fucose to the N-acetylglucosamine residue by the enzyme FUT3 produces Lewis antigens (Lewis a/x, Lewis b/y, A Lewis b/y, B Lewis b/y).
Figure 2
Figure 2
Effectiveness of oral RV vaccines in relation to a country’s per capita GDP. Effectiveness of the four main oral RV vaccines (Rotarix, RotaTeq, Rotavac and Rotasiil) is shown in countries with different gross domestic product (GDP). This Figure was generated according to world development indicators from the Worldbank and vaccine effectiveness studies [66].
Figure 3
Figure 3
RV vaccines under development. The different vaccines are shown stratified by development phase. Oral vaccines are shown in the left column, while parenterally administered vaccines are shown on the right. The boxes with continuous lines in bold indicate licensed products pursuing new formulations.
See this image and copyright information in PMC

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