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December 2021
International Vaccine Access Center
Johns Hopkins Bloomberg School of Public Health

2021 Year In Review

Dear Colleagues,

As another year draws to a close, we would like to take a moment to reflect on both the continued challenges faced and the triumphs achieved in efforts to reduce the burden of rotavirus in children globally. 

In 2021, rotavirus remains a leading cause of diarrhea-associated morbidity and mortality among children under 5—a burden felt most heavily in low- and middle-income countries in Africa and Asia. While new rotavirus vaccine introductions were minimal this year and immunization coverage levels wavered globally, the rigor and persistence of public health efforts remained steadfast. Progress achieved in 2021 included encouraging new research on next generation injectable rotavirus vaccines and the RV3-BB neonatal rotavirus vaccine, WHO prequalifications of ROTAVAC 5D and ROTASIIL-Liquid, and the addition of rotavirus vaccines to the Humanitarian Mechanism.

We are hopeful to make even greater strides in the new year, with a reinvigorated vision to regain lost ground and progress even further in our goals to protect the health of all children in 2022. 

Wishing everyone a safe and healthy start to the new year.

Regards,
Mathu Santosham
Chair

Rotavirus Vaccine Updates In 2021

New rotavirus vaccine introductions 

Rotavirus vaccine introductions were minimal in 2021 but progress was made with some Pacific Islands as rollout of rotavirus vaccine began in August for Samoa, Tonga, and Tuvalu.

Updated WHO rotavirus vaccine position paper

The World Health Organization (WHO) released an updated rotavirus vaccine position paper on Friday, July 16, 2021, the first such update since 2013. The position paper synthesizes new research, data, and developments in the field, such as the WHO pre-qualification of two additional rotavirus vaccines in 2018—ROTAVAC® (Bharat Biotech International Ltd) and ROTASIIL® (Serum Institute of India).

WHO prequalification of ROTASIIL-Liquid and ROTAVAC 5D®

ROTASIIL-Liquid

The ready-to-use, liquid form of ROTASIIL (Serum Institute of India) was prequalified by the WHO in February 2021. Unlike the lyophilized ROTASIIL, the new ROTASIIL-liquid is available in single-dose plastic tubes and does not need to be reconstituted before administration. The ROTASIIL-liquid product has a shelf life of 24 months at a storage temperature of 2-8°C.
ROTAVAC 5D®
A new rotavirus vaccine from Bharat Biotech International Limited, ROTAVAC 5D®, was prequalified by the WHO on June 18, 2021. This liquid formulation of the existing frozen rotavirus vaccine, ROTAVAC®, comes with advantages such as being low dosage, not requiring a buffer, and having storage temperatures of standard refrigeration (2-8°C for up to 24 months). 

Rotavirus vaccines in humanitarian crises 

In 2021, rotavirus vaccines were added to the Humanitarian Mechanism—a partnership between WHO, UNICEF, Médecins Sans Frontières (MSF), and Save the Children that aims to support access to affordable vaccines in humanitarian emergencies. Thanks to a landmark pricing agreement with GSK, this will now allow for children in refugee camps and displaced communities around the world to access these life-saving vaccines. 

13th African Rotavirus Symposium

The 13th African Rotavirus Symposium, held virtually from November 3-4, 2021, was an inspiring convening of rotavirus experts and practitioners. As African countries continue to shoulder the largest burden of childhood deaths due to rotavirus, rotavirus vaccine advocates in Africa are leading the call for sustained momentum against rotavirus despite the challenges of the pandemic.

Read our blogpost on rotavirus vaccination progress in Africa and DefeatDD's key takeaways from the symposium.

Advocacy Initiatives and Resources of 2021


ROTA Champion Series


In 2021, we had the privilege of speaking with some key experts and advocates for rotavirus vaccines around the world from countries including Kenya, Mexico, and South Africa. Our Champion Series aims to share the successes, challenges, and lessons of critical players in the fight against rotavirus. Look out for more interviews in 2022!
 

2021 Pneumonia & Diarrhea Progress Report


IVAC's Pneumonia & Diarrhea Progress Report highlights the impact of the COVID-19 pandemic on progress against two of the leading killers of children. Despite the toll of the pandemic, key gains such as a 29% increase in rotavirus vaccine coverage rates in India over the past year are celebrated.


 

Country Experiences Map


Over the past year we have added new countries and additional coverage data to our interactive country experience map, highlighting the success stories of countries that have introduced rotavirus vaccination, along with information on birth cohort, product, and coverage rates.
 

VIEW-Hub

 
VIEW-hub continues to serve as an up-to-date resource on the introduction status, coverage levels, and product information across all countries for rotavirus vaccines and more. This year, VIEW-hub has expanded to cover typhoid and COVID-19 vaccines.

Are rotavirus vaccines a good investment for middle-income countries?


A new resource from PATH shows that even among non-Gavi eligible middle-income countries, rotavirus vaccination is likely to be highly cost-effective and beneficial.

Untapped: It's time to reimagine the toilet's potential


DefeatDD's "Untapped" campaign brings awareness to the growing issue of climate change and its impact on sanitation and diarrhea. Climate extremes such as flooding, droughts, and famine can increase the burden of waterborne diseases and exacerbate illnesses such as diarrhea. However, sanitation innovations could help mitigate these future impacts of climate change.

New Research of 2021

Vaccine


National stakeholder preferences for next-generation rotavirus vaccines: Results from a six-country study


This 6-country study aims to assess national stakeholder preferences for currently available live, oral rotavirus vaccines (LORVs) and hypothetical next-generation rotavirus vaccine (NGRVs) and understand rationales and drivers for stated preferences. Results show an effective and affordable injectable rotavirus vaccine may be an attractive option to LMICs.

The Lancet Infectious Diseases

 

Community transmission of rotavirus infection in a vaccinated population in Blantyre, Malawi: a prospective household cohort study


Rotavirus vaccine effectiveness is reduced among children in low-income countries. Indirect (transmission-mediated) effects of rotavirus vaccine might contribute to the total population effect of vaccination. This prospective household cohort study aimed to examine risk factors for transmission of rotavirus to household contacts in Blantyre, Malawi, and estimated the effectiveness of rotavirus vaccine in preventing transmission of infection to household contacts. The study finds rotavirus vaccine has the potential to substantially reduce household rotavirus transmission.

The Journal of Infectious Diseases

 

Global Experience With Rotavirus Vaccines


This supplement reviews the expanding rotavirus vaccine landscape and comments on the global successes and challenges of implementing rotavirus vaccines. Looking forward, the authors emphasize the urgency to close the existing regional gaps in rotavirus vaccine coverage to protect more children from severe gastroenteritis.

Clinical Infectious Diseases

 

Impact of Rotavirus Vaccine Introduction on Rotavirus Hospitalizations Among Children Under 5 Years of Age-World Health Organization African Region, 2008-2018

This study describes the impact of rotavirus vaccines in Africa using data from the African Rotavirus Surveillance Network (ARSN). Results found rotavirus vaccine introduction led to large and consistent declines in the proportion of hospitalized AGE cases positive for rotavirus, emphasizing the need to introduce rotavirus vaccines in remaining countries in the region and improve coverage. 

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