article · Vaccines
Rotavirus causes severe dehydrating diarrhoea in infants and young children worldwide. Four live-attenuated oral vaccines, Rotarix, RotaTeq, Rotavac, and RotaSIIL, are currently licensed to protect against rotavirus-associated infections. Although clinical efficacy is noticeably higher in high-income countries than in low- to middle-income nations, the overall health impact is far greater in low-income settings. Despite demonstrated effectiveness, more than ninety countries across Asia, Europe, and the Americas have not yet introduced these vaccines into their national programmes. Adoption continues to face substantial barriers, including product costs, policy hurdles, difficulties in delivering strategic preventative measures, and inadequate local infrastructure. Addressing the lower efficacy observed in poorer regions and understanding early development methods remain vital to expanding global protection.
Rotavirus remains a leading cause of life-threatening diarrhoea among infants and young children. Understanding disparities between vaccine efficacy and practical impact, as well as the infrastructural and financial barriers delaying rollout in over ninety countries, is vital for public health authorities and policymakers seeking to reduce child mortality.
The four licensed vaccines represent commercialised, market-ready preventative health products. However, widespread adoption faces market friction caused by high procurement costs, policy barriers, and cold-chain or health infrastructure limits in target countries. Vaccine manufacturers and public healthcare procurers can target product delivery innovations, cost reductions, and formulation improvements to enhance vaccine performance and accessibility across low- and middle-income regions.
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Safety, efficacy, and cost-effectiveness are paramount to vaccine development. Following the isolation of rotavirus particles in 1969 and its evidence as an aetiology of severe dehydrating diarrhoea in infants and young children worldwide, the quest to find not only an acceptable and reliable but cost-effective vaccine has continued until now. Four live-attenuated oral rotavirus vaccines (LAORoVs) (Rotarix®, RotaTeq®, Rotavac®, and RotaSIIL®) have been developed and licensed to be used against all forms of rotavirus-associated infection. The efficacy of these vaccines is more obvious in the high-income countries (HIC) compared with the low- to middle-income countries (LMICs); however, the impact is far exceeding in the low-income countries (LICs). Despite the rotavirus vaccine efficacy and effectiveness, more than 90 countries (mostly Asia, America, and Europe) are yet to implement any of these vaccines. Implementation of these vaccines has continued to suffer a setback in these countries due to the vaccine cost, policy, discharging of strategic preventive measures, and infrastructures. This review reappraises the impacts and effectiveness of the current live-attenuated oral rotavirus vaccines from many representative countries of the globe. It examines the problems associated with the low efficacy of these vaccines and the way forward. Lastly, forefront efforts put forward to develop initial procedures for oral rotavirus vaccines were examined and re-connected to today vaccines.
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DOI: 10.3390/vaccines8030341
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