Rotavirus vaccines found risky for infants even as India goes ahead including vaccine in immunization programme

Rotavirus vaccine has been recently found causing rotavirus diarrhea and other related complication in infants even as India goes ahead with its plan to introduce rotavirus vaccine in its universal immunization programme.

Recently, there have been reported cases of vaccine-acquired rotavirus infection in infants with severe combined immunodeficiency (SCID).

SCID, which includes a group of rare, life-threatening disorders that are caused by more than a dozen single-gene defects and that result in profound deficiencies in T- and B-lymphocyte function.

Infants with SCID commonly experience chronic diarrhea, failure to thrive and early onset of infections.

Diagnosis and hematopoietic stem cell transplantation before onset of severe infections offer the best chance for long-term survival.

The median age at diagnosis of SCID is 4-7 months, which overlaps with the ages for recommended rotavirus vaccination.

Following this,  Merck & Co. Inc. and GlaxoSmithKline Biologicals have revised the prescribing information and package labeling for their respective live rotavirus vaccines.

Merck manufactures a pentavalent rotavirus vaccine, RotaTeq and GlaxoSmithKline manufactures a monovalent vaccine, Rotarix.

The Center for Disease Control in US has updated the list of contraindications for rotavirus vaccine to include infants diagnosed with SCID.

The CDC estimated the annual incidence of SCID at one case per 40,000-100,000 live births, or 40,100 new cases among U.S. infants each year.
Insia is now conducting initial studies to include rota virus vaccine its universal immunization frogramme for children.

About 527,000 young children die from rotavirus-induced diarrhea annually, 85 percent of them in lower-income countries of Africa and Asia, WHO says. Fourteen of those nations are eligible for funding to buy vaccines through the GAVI Alliance, a group supporting childhood immunization in poor countries.

Rotavirus is prevalent in India and the sub-Saharan African region. In the US alone. A vaccine against rotavirus is expected save one lakh children in India every year.

The biggest challenge to developing a vaccine against rotavirus is its diversity. The rotavirus strains have been classified into seven groups. The most harmful rotavirus occur in group a, which is sub-divided into categories such as g1, g2 and g3, depending on the way they react with the host’s blood, or their serotype, in medical parlance. g serotypes 1-4 and 9 are found widely. g9 strains, believed to have originated in India in the 1990s, have now become the predominant rotavirus variants in several nations.

A major reason for the presence of large number of rotaviral strains in India (and in other Asian countries, too) is the proximity between people and animals such as cattle and pigs.