Diarrhea is a very serious problem throughout the world. You might not know it if you live in the US, but diarrhea is the #2 cause of death in the world for children age 5 and under. Here we have great treatments for diarrhea – clean water, electrolyte solutions, and IV rehydration. But in the developing world, these are all in short supply, and many children die of diarrheal illness without even getting to a hospital.
There is also a vaccine for one of the leading causes of severe diarrhea, called rotavirus infection. Rotavirus vaccine, now used in most developed countries, has dropped the death rate from diarrheal disease in children tremendously. However, the vaccine is not available in many areas of the world, and has a complicated history in the U.S.
The original version of the rotavirus vaccine, called Rotashield, was licensed in 1998. It was pulled off the market after several months when an association was noted between getting the vaccine and developing a condition called intussusception, an intestinal blockage. Vaccine manufacturers were eager to replace it but had to run many trials to be sure that newer products did not cause the same side effect. It took until 2006 for the first replacement (called Rotateq) to get licensed. 2 years later, Rotarix was also licensed by a competitor. Bother are oral vaccines, and are normally given at the same time as other vaccines. Each vaccine requires a different number of doses. Both have been extensively evaluated and do NOT cause intussusception. We are thrilled to have less babies in the emergency room receiving IV fluids!
Next task is to get this vaccine cost down for the parts of the world where it is too expensive to use routinely.
Here’s an article from August 2018 that discusses the impact of Rotavirus vaccine on the developed vs the developing world:
Dosing in the U.S.:
- 3 doses, given at 2 months, 4 months, and 6 months of age
- 2 doses, given at 2 months and 4 months of age