Polio endgame: Lessons for the global rotavirus vaccination program |
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| Affiliation: | 1. Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA;2. Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA;3. Fogarty International Center, National Institutes of Health, Bethesda, MD, USA;1. Servicio de Aparato Digestivo, Hospital Universitari del Sagrat Cor, Barcelona, España;2. Servicio de Cirugía General y Digestiva, Hospital Universitari del Sagrat Cor, Barcelona, España;3. Servicio de Medicina Interna, Hospital Universitari del Sagrat Cor, Barcelona, España;1. Department of General Surgery, University of Health Sciences Tepecik Training and Research Hospital, Yenişehir/Konak/İzmir, Turkey;2. Department of Pathology, University of Health Sciences Tepecik Training and Research Hospital, Yenişehir/Konak/İzmir, Turkey;1. Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Science, Tehran, Iran;2. Network of Immunology in Infections, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran;3. Cancer Immunology Project (CIP), Universal Scientific Education and Research Network (USERN), Tehran, Iran;4. Division of Clinical Immunology, Department of Laboratory Medicine, Karolinska Institute at Karolinska University Hospital Huddinge, Stockholm, Sweden;5. Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran;6. Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran;7. Department of Immunology, Institut Pasteur de Tunis and University Tunis El-Manar, Tunis, Tunisia;8. Center for Vaccine Equity, Task Force for Global Health, Atlanta, GA, United States;1. Indian Institute of Technology Mandi, VPO Kamand, Himachal Pradesh 175005, India;2. Department of Molecular Medicine and Byrd Alzheimer''s Research Institute, Morsani College of Medicine, University of South Florida, Tampa, FL, United States;3. SRM University, AP – Amaravati, Neerukonda, Mangalagiri Mandal Guntur District, Mangalagiri, Andhra Pradesh 522502, India;4. BioX Center, Indian Institute of Technology Mandi, Himachal Pradesh, India |
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| Abstract: | Poliovirus and rotavirus share notable similarities. Although rotavirus is not amenable to eradication because of animal reservoirs, live, attenuated oral vaccines have been the bedrock of both prevention and control programs, providing intestinal and humoral immunity. Both programs have also encountered safety concerns and suboptimal immune responses to oral vaccines in low-income settings that have been challenges, prompting the search for alternative solutions. In this paper, we review the progress made by polio prevention and eradication efforts over the past six decades. Specifically, we discuss the roles of the oral polio vaccine (OPV) and the inactivated polio vaccine (IPV) in achieving polio eradication, and explore potential application of these lessons to rotavirus. Recent scientific evidence has confirmed that a combined schedule of IPV and OPV adds synergistic value that may give the polio eradication effort the tools to end all poliovirus circulation worldwide. For rotavirus, oral vaccine is the only currently licensed and recommended vaccine for use in all children worldwide, providing heterologous protection against a broad range of strains. However, parenteral rotavirus vaccines are in the pre-clinical and clinical trial stage and insight from polio provides strong justification for accelerating the development of these vaccines. While challenges for parenteral rotavirus vaccines will need to be addressed, such as achieving protection against a broad range of strains, the principle of combined use of oral and parenteral rotavirus vaccines may provide the necessary humoral and intestinal immunity necessary to close the efficacy gaps between developing and developed countries, therefore controlling rotavirus worldwide. This strategy may also potentially reduce risk of intussusception. |
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| Keywords: | Poliovirus Rotavirus Rotavirus vaccine Oral polio vaccine Inactivated polio vaccine |
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