Monthly Progress Update
January/February 2016

A Letter from the Chair
Dear ROTA Council members, partners, and supporters:
Welcome to the first ROTA Council progress update for 2016. Eight countries introduced rotavirus vaccines into their national immunization programs in 2015, but more than 90 million children still lack access to rotavirus vaccines. This year, ROTA Council members and partners will be engaging in technical and advocacy opportunities around the world as we work to accelerate vaccine introduction and promote a comprehensive approach to reducing the burden of rotavirus diarrhea and improving child health.
Since December, we have been working to improve our progress updates and website to make them more comprehensive and user-friendly. We welcome your feedback on the new designs. In this month’s update, you will find a feature on a new Asia-focused fact sheet in the advocacy toolkit and an introduction to our new 2016 Active Member Committee, as well as some reminders from the previous updates.
As always, if you have any information you’d like to share with the Council, please let us know and we will include it in the next update.

Best regards,

Mathu Santosham
  1. News and Announcements
  2. New Research Studies
  3. Recent Member Publications
News and Announcements 
2016 Active Member Committee
Since the ROTA Council was established in 2011, we have grown to include a robust group of over 20 experts from more than 15 countries across all WHO regions. This year, we are launching an “Active Member Committee”—Council members that sign on for a one-year commitment to advance the introduction or rotavirus vaccines in several concrete ways.

Their commitments for 2016 include leading technical briefings with decision makers in countries that have not yet introduced rotavirus vaccines, engaging civil society organizations to strengthen advocacy, and writing opinion editorials in influential news media outlets. Read more about the committee here.

The 2016 Active Member Committee members are:

George Armah (Ghana)
Julie Bines (Australia)
Lulu Bravo (Philippines)
Nigel Cunliffe (UK/ Malawi)
Zulkifli Ismail (Malaysia)
Alexandre Linhares (Brazil)
Tony Nelson (Hong Kong)
Kathy Neuzil (USA)
Deborah Atherly (USA)
Umesh Parashar (USA)
Duncan Steele (USA)
Mathu Santosham (USA)
ROTA Council Symposium in Hyderabad
On 21 January, the ROTA Council hosted a symposium on rotavirus vaccines in Asia during the Asia Pacific Congress of Pediatrics (APCP), Asia Pacific Congress of Pediatric Nursing (APCPN), and Annual Conference of the Indian Academy of Pediatrics (PEDICON) in Hyderabad, India.

The session was chaired by Zulkifli Ismail and Mathuram Santosham and featured presentations from Gagandeep Kang on the regional burden of disease; Jacqueline Tate (CDC) on rotavirus vaccine efficacy, effectiveness, and impact; and Tony Nelson on rotavirus vaccine costing and financing. The session closed with a panel discussion on opportunities and challenges for rotavirus vaccine interaction in Asia; Gagandeep Kang, Tony Nelson, Lulu Bravo, and Ruhul Amin (Bangladesh Institute of Child Health) served as panelists. The symposium was well attended by representatives from many Asian countries. Attendees received a copy of the executive summary for the ROTA Council White Paper; the paper is undergoing final review now and will be posted to the ROTA Council website once complete. We are very grateful for the input from all the Council members in finalizing the White Paper.

New Research Studies 

Rwanda Impact Study Results
Rwanda introduced rotavirus vaccines in 2012, becoming the first first low-income African country to introduce pentavalent rotavirus vaccine into its national immunization program.

Researchers from Rwanda’s Ministry of Health, CDC, WHO, and partner organizations examined trends in pediatric hospital admissions from 2009 to 2014 and looked at other epidemiological evidence from the country. 

Hospital admissions for acute gastroenteritis decreased by about half and rotavirus-specific admissions declined by 61-70% following introduction of rotavirus vaccine in the routine national immunization program. The greatest effect was recorded in children of vaccination age, but researchers noted a decrease in rotavirus diarrhea hospitalizations in almost every age group, suggesting herd immunity. This paper provides the first evidence of indirect protection from rotavirus vaccination in a high-burden, low-income setting and the first data demonstrating the impact of routine pentavalent rotavirus vaccination in Africa. 

Read the full paper in The Lancet Global Health here.
Rotavirus vaccination in Rwanda
Photo credit: ©UNICEF/Cyriaque Ngoboka/UNICEF Rwanda.
Return on Investment from Childhood Immunization
To quantify the economic benefits of immunization, researchers from the Johns Hopkins Bloomberg School of Public Health and coauthors assessed the return on investment over a ten-year period (2011-2020).

The study, covering 94 low- and middle-income countries, shows that:
  • Net benefits exceeded costs across all ten antigens during the decade. 
  • For every dollar invested in childhood immunization we can expect to save US$ 16 in healthcare costs, lost wages and productivity due to illness and death.
  • If we take into account the full value of people living longer, healthier lives, the return on investment rises to US$ 44. 
  • In total, immunization will yield more than US$ 586 billion in economic benefits in the period 2011-2020.
The return on investment depends heavily on the ability to raise the financial investments necessary to achieve projected coverage rates, which will require continued commitment from governments and donors. 

Read the full Health Affairs paper here.
Recent Member Publications

Each month we highlight recent publications authored by Council members and core partners. View all recent member publications on the ROTA Council website.

Can changes to scheduling enhance the performance of rotavirus vaccines in low income countries? Cunliffe NKang G. J Infect Dis. 2016 Jan 27. pii: jiw026. [Epub ahead of print]

Effect of pentavalent rotavirus vaccine introduction on hospital admissions for diarrhoea and rotavirus in children in Rwanda: a time-series analysis. Ngabo F, Tate JE, Gatera M, Rugambwa C, Donnen P, Lepage P, Mwenda JM, Binagwaho A, Parashar UD. Lancet Glob Health. 2016 Feb;4(2):e129-36.

Evaluation of rotavirus disease burden and vaccine effectiveness in India. Kang G, Tate JE, Parashar UD. Vaccine. 2015 Dec 16;33(51):7143. 

Non-interference of rotavirus vaccine with measles-rubella vaccine at 9 months and improvements in anti-rotavirus immunity: a randomized trial. Zaman K, Fleming JA, Victor JC, Yunus M, Bari TI, Azim T, Rahman M, Mowla SM, Bellini WJ, McNeal M, Icenogle JP, Lopman B, Parashar U, Cortese MM, Steele AD, Neuzil KM. J Infect Dis. 2016 Jan 27. [Epub ahead of print]

A Randomized Controlled Trial of the Impact of Alternative Dosing Schedules on the Immune Response to Human Rotavirus Vaccine in Rural Ghanaian Infants. Armah G, Lewis KD, Cortese MM, Parashar UD, Ansah A, Gazley L, Victor JC, McNeal MM, Binka F, Steele AD. J Infect Dis. 2016 Jan 27. [Epub ahead of print]

View more...

Click here to complete the 2016 event participation survey
Advocacy Toolkit Spotlight
The new Rotavirus in Asia fact sheet highlights the burden of disease and status of vaccine introduction in Asia. Find it in the advocacy toolkit
Introduction Updates
As of December 2015, 80 countries include rotavirus vaccines in their national immunization programs. A full list is available on the website.
March 2-5, 2016
17th International Congress on Infectious Diseases
Hyderabad, India

April 3-6, 2016
53rd Philippine Pediatric Society Annual Convention
Pasay City, Philippines

May 10-14, 2016
34th Annual Meeting of the European Society for Pediatric Infectious Diseases (ESPID) 
Brighton, UK

June 2-3, 2016 
9th African Rotavirus Symposium
Bamako, Mali

August 17-22, 2016
28th International Congress of Pediatrics (IPA)
Vancouver, Canada

September 7-9, 2016
12th International Rotavirus Symposium
Melbourne, Australia 

November 7-10, 2016
8th Asian Congress of Pediatric Infectious Diseases (ACPID)
Bangkok, Thailand

November 13-17, 2016
American Society of Tropical Medicine and Hygiene (ASTMH) 65th Annual Meeting
Atlanta, USA
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