30.11.2020

Expert opinion: whether vaccination against rotavirus?

About what rotavirus is why you need to get vaccinated and the vaccination, editorial News.Medicine told Alexander V. Gorelov, corresponding member of RAS, MD, Professor, Department of childhood diseases of the First MGMU them. I. M. Sechenov, head of children’s clinical departments crie.

When did the rotavirus vaccine, how it works?

There are 2 oral rotavirus vaccine. Both have a prequalification from the world health organization, registered in more than 100 countries. In Russia was only one – pentavalent oral vaccine (manufactured by MSD), which contains five live rotavirus strains.

The vaccine helps produce immunity against rotavirus infection in children. The rotavirus vaccine is a composite – it contains the certain areas of the genome that cause the most favorable immune response. This combination provides good protection against the constantly mutating viruses.

In some countries it is included in the vaccination calendar?

Given the high infectivity of rotavirus infections )rvi) and the lack of effectiveness of non-specific prevention measures (sanitation), the lack of specific treatment, currently the single most effective method of monitoring the incidence of rotavirus vaccination is recognized.

The world health organization (who) strongly recommends the inclusion of rotavirus vaccine in the national immunization programs of all countries of the world. In the foreseeable future, experts do not expect the creation of an effective cure for the rotavirus. If the child contracted this infection, may cause a number of life-threatening complications, the pediatrician remains only a symptomatic treatment. On the other hand, the effectiveness of vaccination against tear so high that this measure for the vast majority of inoculated simply eliminates the need of treatment tear.

The vaccine used in the world for more than 10 years in the United States, mass vaccination against the tear was first introduced in 2006. Today, the experience in foreign countries, the age of children subject to vaccination, these preventive medications show a decrease in the incidence of tear 79-94%.

To date, 94 countries in the world (including USA, Australia, European countries, Mexico, Brazil) fully or partially implemented vaccination against rvi in the National immunization schedules. According to the who studies, a reduction in the incidence of RVGE in 79-94% among vaccinated infants in the period 2010-2011 in populous countries such as Mexico and Brazil. In addition, based on the results of 6 national and international studies conducted in the period from 2006 to 2011, a 36% decrease in the number of requests for medical help for gastroenteritis in the population aged 5-59 years not subject to immunization.

In Russia at the moment vaccination against tear included in the national calendar of preventive vaccinations only on epidemiological evidence, and only in 4 cities used in the framework of the regional immunization schedule in Moscow, Yekaterinburg, Tyumen and Achinsk (the Krasnoyarsk territory).

Who are vaccinated?

To start to vaccinate against rotavirus is necessary from 6 weeks to to the peak incidence of this infection (6-12 months) the child was already protected from it. Course of vaccination against tear consists of 3 doses with an interval between doses 4 to 10 weeks. All three doses are recommended to introduce until the child reaches the age of 32 weeks of life.

The vaccine against rotavirus in the form of solution and is intended for oral administration, it can be administered to children at the same time (in one day) with any of the vaccines of the National calendar of preventive vaccination and vaccination on epidemic indications (except BCG/BCG-m). The vaccine often causes no complications, because it is oral. It can be administered even premature babies and babies with immune deficiency.

In Russia the vaccine is to be included in the national calendar in 2020. How much time left for this decision was the conduct of pilot programs in the regions?

With 2014 in Russia vaccination against tear included in the second part of the National calendar of preventive vaccinations (epidotization), implemented a regional program of vaccination.

The results of the vaccination programme RIP 2015 in Krasnoyarsk region recorded a decline in the number of hospitalizations for acute intestinal infections in the infectious diseases Department in the vaccinated group (0 to 1 year) and among unvaccinated children aged 1 to 3 years; for emergency treatment for acute intestinal infections have received less of both adults and children.

Good results have been achieved with vaccination tear in Tyumen, the Khanty-Mansi Autonomous district, Moscow region. Pentavalent vaccine was well tolerated and was safe, was demonstrated its prophylactic efficacy in the form of prevented moderate and severe gastroenteritis and hospitalization.

The collected data confirm the effectiveness of specific prevention tear for disease control and reduction, as well as reducing the need for hospitalisation of children. Moreover, it contributes to lower health care costs.

Unfortunately, in 2016, the vaccination rate against rvi in Russia did not exceed 2.0% of the target group. The early introduction of mass vaccination against the tear in the Russian Federation is one of the most urgent tasks. Annual vaccination of 70% of children would reduce the costs of RVGE, 4,399 billion rubles per year, of which 2,342 billion rubles for outpatient and 2,057 billion rubles on inpatient care, which will have a huge positive impact on the entire organization to help children and to prevent significant economic damage.

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