Progress Update: September 2017

A Letter from the Chair

Dear Colleagues,

I am excited to welcome a new member of our Council. Dr. Fredrick Were, dean of the School of Medicine at the University of Nairobi, is known for his passionate advocacy for childhood immunization and his leadership roles over many years in in national, regional, and global advisory groups. He is already raising important issues within the Council, such as ensuring good coverage in countries that have recently introduced rotavirus vaccine.

Speaking of introductions, as India rolls out access to rotavirus vaccines for millions of infants in five more states—Assam, Tripura, Madhya Pradesh, Rajasthan, and Tamil Nadu—data continues to accumulate demonstrating strong and swift impact in countries that have earlier introduced rotavirus vaccines. See below for a summary of a Journal of Infectious Diseases review or search on IVAC's VIEW-hub tool for impact studies.
Dr. Mathu Santosham
Chair, ROTA Council
In this edition...

Welcome Dr. Fred Were to ROTA Council!

Newest member of ROTA Council is Dean of University of Nairobi School of Medicine

ROTA Council is delighted to welcome Dr. Fred Were as our newest Council member. Professor Were is committed to increasing childhood immunization coverage and public awareness. Having served for three years as president of the International Society of Tropical Paediatrics, Dr. Were is currently president of the Eastern African Paediatric Association, a member of the Global Rotavirus Academy, and sits on Kenya's National Immunization Coordinating Committee.

Read Dr. Were's full bio here.

New Research: ROTASIIL vaccine efficacy in India

Results from a Phase 3 efficacy study in India of the Serum Institute of India Pvt. Ltd.’s rotavirus vaccine BRV‐PV (known as ROTASIIL®) were published today in the journal Vaccine. The study showed the vaccine to be safe, well tolerated, and to provide significant efficacy against severe rotavirus gastroenteritis. 

ROTASIIL reduced severe rotavirus diarrhea by more than a third – 39.5 percent over two years.

The results demonstrated by ROTASIIL in India appear generally comparable to the performance of RotaTeq® and Rotarix® in Bangladesh and in some African countries.

Dr. Rajeev Dhere, executive director of the Serum Institute, commented, “We are delighted with these results, which indicate that ROTASIIL could save the lives of tens of thousands of children each year in India and, potentially, around the world.”

The Government of India has placed an order for 3.8 million doses of ROTASIIL to use in the Universal
Immunization Programme, which serves 26 million children.

Read more about ROTASIIL's efficacy results in India.

Read an article from the New England Journal of Medicine from ROTA Council chair Mathu Santosham and Council member Duncan Steele about the importance of new vaccines such as ROTASIIL to the global supply picture.

Event Summary: Health economics in Eastern Europe 

Twenty-four participants representing EPI staff and researchers from seven countries in Eastern Europe and Central Asia, as well as partners including WHO and ROTA Council, participated in a meeting entitle Informing Vaccine Decision-Making with Health Economics: A Focus on Rotavirus Vaccines. Participants sought to learn and share knowledge on rotavirus disease and tools for economic evaluations.

Clint Pecenka and his team from PATH provided practical training sessions on cost-effectiveness methods such as the updated and enhanced UNIVAC model from the ProVac Initiative, used to generate, use, and communicate economic evidence to strengthen vaccine decision-making. The workshop followed a similar event held in Bangkok last November. 

Event Summary: Expanding supply meeting in Seattle

Technical consensus building on new products and vaccine performance

What evidence is needed for countries to make decisions about new rotavirus vaccine products? What programmatic issues have come up during the rollout of new rotavirus vaccine products in India? What key research questions still exist, what studies are underway, and what will the supply situation look like with new products licensed in India being prequalified by WHO and made available through UNICEF procurement to all countries? 

To address these and other critical questions related to the expanding product pipeline, ROTA Council assembled 30 participants from 10 countries in Seattle to present and discuss the latest data on ROTAVAC (Bharat Biotech), ROTASIIL (Serum Institute of India), RotaTeq (Merck), and Rotarix (GlaxoSmithKline). Participants aside from manufacturers included ROTA Council members and other technical experts on vaccine development, licensure, pre-qualification, supply, feasibility, global policy, implementation, scheduling, and other key questions related to decision making. Stay tuned for a meeting summary.

Featured Research: Hospitalization and deaths drop after rotavirus vaccine in 27 countries 

In The Journal of Infectious Diseases Eleanor Burnett and other authors including Umesh Parashar summarized the impact of rotavirus vaccination on hospitalizations and deaths from rotavirus and all-cause acute gastroenteritis during the first 10 years since licensure of two currently available vaccines.

Authors found that hospitalization decreased dramatically. Across 27 countries, the median reduction in pediatric hospitalization for AGE after rotavirus vaccine introduction was 38%. In countries with high levels of child mortality, hospitalizations went down by 46%. Infant mortality from AGE went down by 31%. 

Read more here.
A JID commentary of Dr. Burnett’s review by ROTA Council members Tony Nelson and Duncan Steele noted that the findings complement and augment data from other meta-analyses. Authors note that while Asia has lagged behind Africa in introducing rotavirus vaccines, India’s newest statewide introductions mean tens of millions more children get vaccinated.
Authors also point to the licensures of ROTAVAC and ROTASIIL as opportunities for augmenting global supply.
See the JID commentary here

Photo of a child getting vaccinated against rotavirus in Ghana by Quarmyne/UNICEF. 

Featured Report: Progress Toward Expanding Rotavirus Vaccine Supply

"The rotavirus vaccine development pipeline," published in Vaccine by Carl Kirkwood, Lyou-Fu Ma, Megan Carey, and Duncan Steele of the Bill & Melinda Gates Foundation, is a resource for those wondering how the vaccine supply picture is projected to change in coming years.
The paper details nationally licensed rotavirus vaccines such as PolyVac’s Rotavin vaccine in Vietnam, as well as rotavirus vaccines under clinical development and testing from Bio Farma (Australia, Indonesia), Serum Institute of India (India), Shantha Biotechnic (India), Wuhan Institute of Biological Products (China), and Institute Butantan, (Brazil). It also describes the development of non-replicating vaccines, including Vp8 expressed proteins being developed by PATH and NIH

Photo of man in Pakistan with rotavirus vaccine stock by Asad Zaidi/ROTA Council. 

Featured Media: Publications following Journalist Training in Singapore

Journalists have published or aired at least 20 stories and broadcast programs following the ROTA Council’s Singapore training for members of the news media on diarrheal disease and rotavirus.  

Among the stories was an elegiac dispatch from a pediatric hospital by Manish Gautam in Nepal's Kathmandu Post (pictured above with ROTA Council members, Drs. Zulkifli Ismail, Mathu Santosham, and Lulu Bravo).
"Each year... parents flock to the emergency units at the Kanti Children's Hospital, infants afflicted with severe diarrhea in tow... The gaunt and haggard faces of the children and those of anxious parents fill up the wards and corridors."

Read more from Nepal reporting.

Learn about the Singapore journalist training.

Browse other stories published after the training

Recent Member Publications

The ROTA Council website is updated bimonthly with new rotavirus and diarrheal disease-related publications authored by Council members and core partners. 

Assessment of Fecal Exposure Pathways in Low-Income Urban Neighborhoods in Accra, Ghana: Rationale, Design, Methods, and Key Findings of the SaniPath Study.
Robb K, Null C, Teunis P, Yakubu H, Armah G, Moe CL. Am J Trop Med Hyg. 2017 Jul 17. [Epub ahead of print]
ASVAC2017: 6th Asian Vaccine Conference.
Goh DYT, Bravo LNelson EAS. Hum Vaccin Immunother. 2017 Aug 31:0. [Epub ahead of print]
The economic impact of childhood acute gastroenteritis on Malawian families and the healthcare system.
Hendrix N, Bar-Zeev N, Atherly D, Chikafa J, Mvula H, Wachepa R, Crampin AC, Mhango T, Mwansambo C, Heyderman RS, French N, Cunliffe NA, Pecenka C; VacSurv Consortium. BMJ Open. 2017 Sep 3;7(9).
The effect of probiotics and zinc supplementation on the immune response to oral rotavirus vaccine: A randomized, factorial design, placebo-controlled study among Indian infants.
Lazarus RP, John J, Shanmugasundaram E, Rajan AK, Thiagarajan S, Giri S, Babji S, Sarkar R, Kaliappan PS, Venugopal S, Praharaj I, Raman U, Paranjpe M, Grassly NC, Parker EPK, Parashar UD, Tate JE, Fleming JA, Steele AD, Muliyil J, Abraham AM, Kang G. Vaccine. 2017 Sep 2. [Epub ahead of print]
Estimated reductions in hospitalizations and deaths from childhood diarrhea following implementation of rotavirus vaccination in Africa.
Shah MP, Tate JE, Mwenda JM, Steele AD, Parashar UD.
Expert Rev Vaccines. 2017 Sep 4:1-9. [Epub ahead of print]

For additional rotavirus-related articles published (or E-published ahead of print) in May-September 2017, click here.

View More Recent Member Publications

VIEW-hub now maps impact studies at global and regional level

You can now use the VIEW-hub mapping tool to visualize the number of published and ongoing studies for rotavirus vaccines and pneumococcal conjugate vaccine, products and dosing schedules evaluated, outcomes evaluated, and more.

Upcoming Conferences

New opportunities for preventing rotavirus in the region
ROTA Council workshop to be held in conjunction with 13th Congress of the Asian Society for Pediatric Research
5 October 2017
Hong Kong

Vaccines for Enteric Diseases
9-11 October 2017
Albufeira, Portugal

Asian Rotavirus Symposium
12-13 October 2017
Delhi, India

ASTMH 66th Annual Meeting
5-9 November 2017
Baltimore, MD

Rotavirus in the media: Outbreaks in Bulgaria, Sydney, Venezuela 

English language news

Rotavirus expert: It's something that affects every child. Frontier Myanmar (Myanmar) 22 August 2017

Panic over new vaccination. The Post (South Africa) 18 August 2017

New two vaccines to be introduced from this year. The Himalayan Times (Nepal) July 21, 2017
Medical practitioners affected by halal debate over vaccination. Free Malaysia Today (Malaysia) July 24, 2017
Gastroenteritis cases up 34 per cent across greater Sydney local health districts. The Daily Telegraph (Australia) August 3, 2017
Other news
Argentina’s vaccination schedule saves lives. (El calendario de vacunación de Argentina salva vidas) 89.9 FM (Argentina) July 4, 2017
How Muldovans can avoid intenstinal infecitons at resort in Bulgaria (Как гражданам Молдовы избежать кишечной инфекции на курортах Болгарии). Sputnik Moldova (Moldova) July 8, 2017
Five serious myths about vaccination and vaccines (خمس خرافات خطيرة عن التلقيح واللقاحات). Arab Youm (Saudi Arabia) July 22, 2017

Child dies from diarrhea complication (Muere niño por complicación de diarrhea). El Informador (Venezuela) August 8, 2017
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