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September 9, 2002

U.S. IMMUNIZATION NEWS

"Rotavirus Vaccines, Take Two"

Scientist (www.the-scientist.com) (08/19/02) Vol. 16, No. 16, P. 34; Beale, Bob

A rotavirus vaccine, originally believed to be an imminent tool in the arsenal of modern medicine after the creation of the smallpox vaccine, has not met its original promise but is gaining interest again in scientific communities as vaccines go through development pipelines.  The public may not be as cognizant of the perils of rotavirus, which strikes in any population, but the illness kills as many as 2,000 children every day worldwide. Though the virus is a simple one, with 11 genes coding three layers of proteins, it is powerful, able to change the activity of over 500 host cell genes within just 16 hours of infection. Rotavirus vaccines are currently in development at Merck and GlaxoSmithKline, with both planning Phase III clinical trials, though Merck's product is from a rearranged bovine rotavirus strain and that of GlaxoSmithKline is a human rotavirus.  They both hope to replace Wyeth's Rotashield, a vaccine that was used from August 1998 to vaccinate roughly 800,000 as part of mandatory vaccination schedules until the product was linked with a rare bowel disorder called intussusception.  The illness is easily treated through surgery and affected just one in 11,000 vaccinees, but Wyeth was forced to remove Rotashield from the market in 1999.  While some experts believe that Rotashield does not cause intussusception and only focuses a child's risk of contracting the disease into a smaller time frame, it appears that the vaccine will [may] never be used again despite its distinct benefits--at least in developed countries.  Nations in which rotavirus is a massive killer, however, could find the risk of intussusception acceptable when compared with the hospitalization rate for rotavirus.

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