Value of post-licensure data on benefits and risks of vaccination to inform vaccine policy: The example of rotavirus vaccines

Parashar, Umesh D.; Cortese, Margaret M.; Payne, Daniel C.; Lopman, Benjamin A.; Yen, Catherine; Tate, Jacqueline E.

doi:10.1016/j.vaccine.2015.05.094

Cited by 24 publications

(12 citation statements)

References 66 publications

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“…3A, D, and E). Similar results were obtained when CD8 + T cells were stimulated with VP7 [33][34][35][36][37][38][39][40] , another immunodominant epitope recognized by H-2 b -restricted CD8 + T cells ( Fig. 3F and G) [22,24].…”

Section: Resultssupporting

confidence: 82%

“…Therefore, LTbR signaling in the myeloid compartment is dispensable for VP6 357-366 -and VP7 33-40 -specific CD8 + T cell responses after RV challenge. However, LTbR signaling in the myeloid compartment may be required to regulate other RV-specific CD8 + T cell IFN-g responses besides those induced by VP6 357-366 and VP7 [33][34][35][36][37][38][39][40] epitopes, as reflected by the increase in CD8 + T cell IFN-g production induced by polyclonal stimulation (Fig. 3A-C).…”

Section: Resultsmentioning

confidence: 99%

“…Although the current 2 licensed, live oral RV vaccines, RotaTeq (Merck, West Point, PA, USA) and Rotarix (GlaxoSmithKline, Research Triangle Park, NC, USA), prevent up to 74% of severe RV episodes [39], the lower vaccine efficacy in resource-poor countries, as well as the risk of intussusception after vaccination are significant problems currently without a solution [40]. One reason for the low vaccine efficacy in the low-income countries is a result of reduced immune responses in infants because of comorbidities or malnutrition, including micronutrient deficiency [41].…”

Section: Resultsmentioning

confidence: 99%

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Hematopoietic LTβR deficiency results in skewed T cell cytokine profiles during a mucosal viral infection

Sun

Rojas

et al. 2015

Journal of Leukocyte Biology

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The lymphotoxin signaling pathway plays an important role in the homeostasis and function of peripheral and mucosal dendritic cells, and dendritic cell-intrinsic lymphotoxin β receptor expression is required for optimal responses to opportunistic intestinal bacteria. However, it is unknown whether dendritic cell-intrinsic lymphotoxin β receptor signaling is required for responses to intestinal viral infections. We explored this question by orally administrating murine rotavirus to chimeric mice that lack lymphotoxin β receptor signaling in the myeloid compartment but retain lymphoid tissues. We found that although clearance of rotavirus was unimpaired in the lymphotoxin β receptor(-/-) → wild-type chimeric mice compared with wild-type → wild-type chimeric mice, IFN-γ-producing CD8(+) and CD4(+) T cells were significantly increased in the small intestinal lamina propria of lymphotoxin β receptor(-/-) → wild-type chimeric mice. In contrast, IL-17-producing CD4(+) T cells were reduced in lymphotoxin β receptor(-/-) → wild-type chimeric mice in the steady state, and this reduction persisted after rotavirus inoculation. In spite of this altered cytokine profile in the small intestinal lamina propria of lymphotoxin β receptor(-/-) → wild-type chimeric mice, the local production of rotavirus-specific IgA was unperturbed. Collectively, our results demonstrate that lymphotoxin β receptor signaling in radio-sensitive myeloid cells regulates the balance of IFN-γ and IL-17 cytokine production within the small intestinal lamina propria; however, these perturbations do not affect mucosal antiviral IgA responses.

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Section: Resultssupporting

confidence: 82%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Hematopoietic LTβR deficiency results in skewed T cell cytokine profiles during a mucosal viral infection

Sun

Rojas

et al. 2015

Journal of Leukocyte Biology

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“…The secondary analysis indicated a significant attributable risk after the second dose of 7.3 excess cases/100,000 infants for the 21-day risk window 34 It will be important to continue monitoring risks associated with Rotavirus vaccines in low income nations as data from high income settings may not directly compare. 45 Ironically, although efficacy of Rotavirus vaccination is lower in developing nations, it is also in such regions that the benefits are of greater magnitude due to higher burden of disease. 33,[46][47][48][49] Taking into consideration the disease burden and associated costs of hospitalization as well as the mortality of Rotavirus gastroenteritis, the impact of vaccination is predicted to be very significant.…”

Section: Vaccination Risks and Benefitsmentioning

confidence: 99%

Rotavirus vaccine efficacy: current status and areas for improvement

Carvalho

Gill

2018

Human Vaccines & Immunotherapeutics

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The difference noted in Rotavirus vaccine efficiency between high and low income countries correlates with the lack of universal access to clean water and higher standards of hygiene. Overcoming these obstacles will require great investment and also time, therefore more effective vaccines should be developed to meet the needs of those who would benefit the most from them. Increasing our current knowledge of mucosal immunity, response to Rotavirus infection and its modulation by circadian rhythms could point at actionable pathways to improve vaccination efficacy, especially in the case of individuals affected by environmental enteropathy. Also, a better understanding and validation of Rotavirus entry factors as well as the systematic monitoring of dominant strains could assist in tailoring vaccines to individual's needs. Another aspect that could improve vaccine efficiency is targeting to M cells, for which new ligands could potentially be sought. Finally, alternative mucosal adjuvants and vaccine expression, storage and delivery systems could have a positive impact in the outcome of Rotavirus vaccination.

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“…Almost all licensed vaccines are associated with side effects, but they vary regarding symptoms and severity. RV vaccination is associated with risk of intussusceptions, a serious disorder where a part of the intestine folds into another section of the intestine. In 1998, United States licensed first RV vaccine with the name Rotashield.…”

Section: Why Do We Need Vaccines For Rotaviruses?mentioning

confidence: 99%

Rotavirus virus‐like particles (RV‐VLPs) vaccines: An update

Changotra

Vij

2017

Reviews in Medical Virology

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Rotaviruses (RVs) cause over 0.2 million deaths annually and are reported to be the foremost cause of gastroenteritis in infants and children worldwide. Vaccination against RVs is the most successful and unsurpassed strategy to combat infection to date. Although the 2 current vaccines, Rotarix and RotaTeq, have dramatically reduced the disease burden, still there is a need for new vaccines. In this context, RV virus-like particles (RV-VLPs) represent potential vaccine candidates as they are noninfectious and effective nonreplicating immunogens that may reduce the risk of side effects related to the conventional vaccines. VLPs being conformationally similar to the parent virus are highly immunogenic and hence provide enhanced protection and better serotype coverage. In this review, we have highlighted the various advantages and the implications of RV-VLPs, discussed the general strategies employed for their production, and talked about the recent developments made in this regard. Overall, the review emphasizes the probable utility of RV-VLPs in eradicating the highly widespread RVs.

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Value of post-licensure data on benefits and risks of vaccination to inform vaccine policy: The example of rotavirus vaccines

Cited by 24 publications

References 66 publications

Hematopoietic LTβR deficiency results in skewed T cell cytokine profiles during a mucosal viral infection

Hematopoietic LTβR deficiency results in skewed T cell cytokine profiles during a mucosal viral infection

Rotavirus vaccine efficacy: current status and areas for improvement

Rotavirus virus‐like particles (RV‐VLPs) vaccines: An update

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