Rotavirus Update

SIXTH INTERNATIONAL ROTAVIRUS SYMPOSIUM BOLSTERS FIGHT AGAINST THE DISEASE
The Sixth International Rotavirus Symposium highlighted efforts to combat the disease and resulted in 16 countries declaring their prioritization of rotavirus as a public health problem. The Symposium was convened and supported by the Pan American Health Organization (PAHO), the World Health Organization (WHO), the Albert B. Sabin Vaccine Institute, the U.S. Centers for Disease Control and Prevention (CDC), the U.S. National Institutes of Health, the Rotavirus Vaccine Program, Aventis-MSD Joint Venture, Merck Research Laboratories (Merck), and GlaxoSmithKline Biologicals (GSK). The Symposium drew 350 participants from around the world, including donors, vaccine manufacturers, government agencies, scientists, public health experts, and clinicians. It strengthened the positioning of rotavirus as a health priority.

Highlighting the importance of rotavirus to Mexico and to the entire region, Mexican Health Minister Dr. Julio Frenk opened the conference, calling the disease a "major public health priority."

Health officials from 16 Latin American countries delivered a declaration heralding immunization as a public good for the region (for a listing of the countries, see this PAHO press release). They called upon PAHO and its Revolving Fund for Vaccine Procurement to work with collaborating agencies, national and global health organizations, and vaccine manufacturers "to facilitate the introduction of vaccines against rotavirus at prices accessible to all countries of the region as soon as they become available."

Symposium Resulted in Extensive Media Coverage; RVP Director John Wecker and Umesh Parashar of the CDC on National Public Radio
Communication efforts around the Mexico City meeting were successful in raising the global profile of rotavirus. Press coverage included articles in newspapers across Latin America and the United States, and on newswires and websites around the world. Newspapers included the Miami Herald, USA Today, and the Edmonton Journal; and newswires included the AP Wire, Reuters, the UN Wire, and XINHUA. On July 9 RVP Director John Wecker, RVP team member Umesh Parashar of the CDC, and Jose Ignacio Santos of the Mexico City Children's Hospital were interviewed on National Public Radio's All Things Considered.

Newswires and press releases:
http://www.paho.org/English/DD/PIN/pr040707b.htm
http://www.paho.org/English/DD/PIN/pr040707a.htm
http://www.unwire.org/UNWire/20040708/449_25681.asp

Surveillance and Mortality Data Increase Awareness
Rotavirus surveillance and mortality data presented at the symposium underscored the urgency of combating rotavirus to improve child survival. Investigators from Latin America, Africa, and Asia presented rotavirus surveillance data, which revealed how efforts are being undertaken in many parts of the globe most seriously affected by the disease. Preliminary analysis of mortality data finds that rotavirus accounts for approximately 39 percent of all diarrheal deaths, up from the previous estimate of 22 percent. This would mean 608,000 children under five die from rotavirus every year, according to researchers at the CDC.

The Symposium's final two sessions focused on vaccine introduction and Expanded Programme on Immunization (EPI) implementation. Panelists presented vital analysis of health economics, financing mechanisms, and communication issues. These sessions highlighted the role of organizations such as RVP, GAVI, WHO, manufacturers, and other public-private partnerships.

Moving Forward With the New Rotavirus Vaccine
Conference participants also heard reports on vaccines under development, including preliminary results from clinical trials conducted by GSK and Merck. Both trials have enrolled more than 60,000 children, and preliminary evidence suggests that both vaccines are promising. In addition, researchers reported on a number of alternative vaccine approaches: bovine vaccine, rhesus vaccine, neonatal vaccines, and inactivated vaccines.

Reassessment of past rotavirus vaccines accompanied the discussion of next-generation vaccines. In particular, new analysis of the risks and benefits associated with Rotashield™ (which was voluntarily withdrawn from the U.S. market in 1999) indicated that the associated risk of intussusception was much lower than previously thought and strongly dependent on age of first dose.*

*Murphy BR, Morens DM, Simonsen L, et al. Reappraisal of the association of intussusception with the licensed live rotavirus vaccine challenges initial conclusions. Journal of Infectious Diseases. 2003;187:1301-1308.

MEXICO ANNOUNCES APPROVAL OF ROTARIX™; PLANS FOR PUBLIC-SECTOR INTRODUCTION IN 2005
On July 14, 2004, Mexico's Board of Health approved GSK's new vaccine, Rotarix™, an oral, two-dose vaccine, for the prevention of rotavirus infection. GSK plans to introduce Rotarix™ to the private sector in Mexico this fall, and the Mexican Ministry of Health is making plans to introduce the vaccine into to the public sector there in April 2005.

Press links:
http://www.medicalnewstoday.com/medicalnews.php?newsid=10757
http://www.gsk-bio.com/webapp/PressCorner/PressDetail.jsp?PressId=10390

ADIP ROTAVIRUS VACCINE WORKING GROUP ESTABLISHED
At their July meeting, the GAVI Board agreed to establish an Accelerated Development and Introduction Plan (ADIP) Rotavirus Vaccine Working Group. The working group met for the first time in August and includes members from the GAVI Secretariat, the ADIP Management Committee, UNICEF, WHO, the Vaccine Fund, the Bill & Melinda Gates Foundation, and RVP.

The Rotavirus Vaccine Program is a limited liability company of PATH.