Combination vaccines against diarrheal diseases

Abstract

Diarrheal diseases remain a leading cause of global childhood mortality and morbidity. Several recent epidemiological studies highlight the rate of diarrheal diseases in different parts of the world and draw attention to the impact on childhood growth and survival. Despite the well-documented global burden of diarrheal diseases, currently there are no combination diarrheal vaccines, only licensed vaccines for rotavirus and cholera, and Salmonella typhi-based vaccines for typhoid fever. The recognition of the impact of diarrheal episodes on infant growth, as seen in resource-poor countries, has spurred action from governmental and non-governmental agencies to accelerate research toward affordable and effective vaccines against diarrheal diseases. Both travelers and children in endemic countries will benefit from a combination diarrheal vaccine, but it can be argued that the greater proportion of any positive impact will be on the public health status of the latter. The history of combination pediatric vaccines indicate that monovalent or single disease vaccines are typically licensed first prior to formulation in a combination vaccine, and that the combinations themselves undergo periodic revision in response to need for improvement in safety or potential for wider coverage of important pediatric pathogens. Nevertheless combination pediatric vaccines have proven to be an effective tool in limiting or eradicating communicable childhood diseases worldwide. The landscape of diarrheal vaccine candidates indicates that there now several in active development that offer options for potential testing of combinations to combat those bacterial and viral pathogens responsible for the heaviest disease burden—rotavirus, ETEC, Shigella, Campylobacter, V. cholera and Salmonella.

Preliminary Work Towards Finding Proteins as Potential Vaccine Candidates for Vibrio cholerae Pakistani Isolates through Reverse Vaccinology

“…R4-368. This protein can be used to made a combine vaccine as their is a need for combined vaccine as well [32]. To validate these findings we had define tertiary structures and active sites of these proteins.…”

Presentation matters: Buffers, packaging, and delivery devices for new, oral enteric vaccines for infants

“… 2 Recent impact studies indicate that immunizing against these two causes of diarrhea could benefit global public health significantly, particularly if they could be combined into a single vaccine for efficient immunization. 3,4 Such a vaccine would improve the health of infants and children in developing countries, and also could protect travelers and military personnel in areas where these bacteria are endemic.…”

Cost-effectiveness analysis of a physician deployment program to improve access to healthcare in rural and underserved areas in the Philippines

“…Diarrhoea caused by viruses (referred to as viral gastroenteritis) are mainly treated through symptomatic support such as through oral rehydration therapy 28 29. Vaccines are available for selected pneumonia and diarrhoea pathogens (eg, S. pneumoniae , Hib, influenza, rotavirus, cholera and so on) and several have been rolled out in the Philippines 26 30 31. However, uptake throughout the country has been variable due to several cost and accessibility barriers 32–34…”