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  • Title: Public health considerations for the introduction of new rotavirus vaccines for infants: a case study of tetravalent rhesus rotavirus-based reassortant vaccine.
    Author: Clemens J, Keckich N, Naficy A, Glass R, Rao M.
    Journal: Epidemiol Rev; 1999; 21(1):24-42. PubMed ID: 10520471.
    Abstract:
    This paper discusses considerations in public health for the introduction of tetravalent rhesus rotavirus-based reassortant vaccine (RRV-TV) for infants. RRV-TV contains a mixture of G1, G2, and G4 reassortants with a parent strain of MMU 18006. Field trials were performed to evaluate the protective efficacy of RRV-TV in infants and to determine the efficacy of RRV-TV higher-dose regimen. The use of RRV-TV in infant immunization brings about the following relevant issues: 1) availability of alternative or complementary non-vaccine interventions; 2) burden of disease; 3) epidemiologic features of rotavirus disease; 4) protective characteristics of the vaccine in efficacy trials; 5) clinical effectiveness of the vaccine; and 6) balance between costs and benefits of vaccination. Moreover, due to its high cost, RRV-TV would not be a cost-saving public health tool in developing countries unless it is made affordable. An effective vaccine against rotavirus is needed due to the following factors: 1) immense burden of rotavirus; 2) persistence of disease burden despite the promotion of rehydration therapy for acute diarrheas in childhood; and 3) lack of effectiveness of nonvaccination approaches.
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