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Progress Update
Summer 2016

A Letter from the Chair

Dear ROTA Council members, partners, and supporters:
 
In June, the Council’s intussusception meeting report was published online in Human Vaccines & Immunotherapeutics, ahead of print. This paper stems from our June 2014 meeting held in Washington, D.C., and highlights scientific consensus around rotavirus vaccines and intussusception, particularly in low- and middle-income countries. Addressing concerns around intussusception and voicing the consensus around the risks and benefits associated with rotavirus vaccines is critical, as we advocate for introductions in the countries where the vaccine is needed most.
 
Nigeria, one of the countries with the highest rotavirus mortality rates, received approval in July from Gavi for the rotavirus vaccine introduction plan. The National Primary Healthcare Development Agency (NPHCDA) had leveraged the work of a previous proposal that the ROTA Council helped to develop. This is a huge milestone with the potential to avert an additional 10,000 child deaths. The two-phased introduction is slated to begin January 2018 and July 2018.
 
Even more good news: Pakistan was approved by Gavi to introduce rotavirus vaccine, starting in one province later this year and nationwide in 2017. Also, I recently returned from Bangladesh, where I was delighted to hear from the health secretary that the country has reaffirmed their commitment to rotavirus vaccine introduction.
 
Additionally, Myanmar (Burma) has enjoyed media attention for its plans to introduce pneumococcal conjugate vaccines into the national immunization schedule. Building on the momentum, the National Committee for Immunization Practices (NCIP) has recommended introducing rotavirus vaccines as well—a pivotal step on the long road to implementation.
 
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
In this edition...

News and Announcements 

International Rotavirus Symposium

The International Rotavirus Symposium will be held in Melbourne, Australia, on September 7-9, 2016. The conference will include updates on rotavirus vaccines, early experiences with introduction of new rotavirus vaccines, epidemiology and burden of rotavirus disease, the pipeline for rotavirus vaccines, and next steps for rotavirus vaccines. More information is available on the symposium website.

The ROTA Council plans to hold a strategy meeting on Tuesday, September 6 for core partners, Council members, and support team members to discuss and plan next steps for the second phase of the ROTA Council. A post-conference advocacy workshop is also planned and will be held on September 10. This session will provide interactive training on effective advocacy strategies for rotavirus vaccines and routine immunization, particularly for the Asia Pacific region. More information will be coming soon about both of these sessions.

Recap: African Rotavirus Symposium

The African Rotavirus Symposium was held in Bamako, Mali, on June 1-2, 2016. The ROTA Council co-sponsored the conference, which brought together representatives from across the continent to discuss new impact study findings, ongoing surveillance efforts, the burden of rotavirus in the region, and ways forward for reducing rotavirus morbidity and mortality in African countries. Special thanks goes to Council members Kathy Neuzil, Duncan Steele, George Armah, and Umesh Parashar for their leadership in planning and hosting the symposium.

June 2016 VIEW-hub Report

The June 2016 VIEW-hub Report on Global Vaccine Introduction and Implementation from IVAC at Johns Hopkins is available here.

VIEW-hub, IVAC's newly launched data visualization platform, and its supporting databases provide the data and maps that were used in this report.    

Recent vaccine introduction updates, from March 2016 through June 2016, include how rotavirus vaccine has been introduced in Liberia.

Featured Research

Rotavirus Vaccination and Intussusception

ROTA Council convened a meeting of research and public health experts and vaccine manufacturers to discuss post-marketing intussusception surveillance and rotavirus vaccine impact data in June 2014. The meeting report has been published ahead of print in Human Vaccines & Immunotherapeutics: “Rotavirus vaccination and intussusception - science, surveillance, and safety: a review of evidence and recommendations for future research priorities in low and middle income countries.” 
 
Key stakeholders and technical experts at national and global levels of policymaking reviewed the risks of intussusception in conjunction with the demonstrated benefits of rotavirus vaccination, including data demonstrating significant reductions in rotavirus hospitalizations, all-cause gastroenteritis hospitalizations among children under 5, and herd immunity in older children and adults.

Here are two key takeaways from the proceedings:
  • Policymakers in Australia, Brazil, Mexico, and the United States concluded that the benefits of rotavirus vaccination far outweigh the risks of intussusception and continue to recommend rotavirus vaccination in their countries.
  • The Global Advisory Committee on Vaccine Safety (GACVS) of WHO has acknowledged the risk of intussusception following the use of rotavirus vaccines, but has also concluded that the risk of intussusception remains small in comparison to the benefits of rotavirus vaccines in preventing severe diarrhea.
Special thanks to the authors of this cornerstone work: Catherine Yen, Kelly Healy, Jackie Tate, Umesh Parashar, Julie Bines, Kathy Neuzil, and Duncan Steele.

Rotavirus Publications

For additional rotavirus-related articles published (or Epublished ahead of print) in May-July 2016, please click here.

Recent Member Publications

The ROTA Council website is updated bimonthly with new rotavirus and diarrheal disease-related publications authored by Council members and core partners. View all of these recent member publications from May-July 2016 on the ROTA Council website.

Clinical Infectious Disease Rotavirus Supplement

CID released the electronic version of the May 2016 supplement, Health Benefits of Rotavirus Vaccination in Developing Countries. The supplement features 20 articles highlighting new evidence on the global burden of rotavirus disease and the impact, effectiveness, and cost-effectiveness of rotavirus vaccines in developing countries.

More Publications

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 Jun 1;213(11):1678-85. Epub 2016 Jan 27.
 
Can Changes to Scheduling Enhance the Performance of Rotavirus Vaccines in Low-Income Countries? Cunliffe NA, Kang G. J Infect Dis. 2016 Jun 1;213(11):1673-5. Epub 2016 Jan 27.
 
Decline in Emergency Department Visits for Acute Gastroenteritis Among Children in 10 US States After Implementation of Rotavirus Vaccination, 2003 to 2013. Shah MP, Tate JE, Steiner CA, Parashar UD. Pediatr Infect Dis J. 2016 Jul;35(7):782-6.
 
Evaluation of Effectiveness of Mixed Rotavirus Vaccine Course for Rotavirus Gastroenteritis. Payne DC, Sulemana I, Parashar UD; New Vaccine Surveillance Network. JAMA Pediatr. 2016 Jul 1;170(7):708-10. 
 
View the full list here.
 
Council members and core partners wishing to add additional or missing relevant publications to the website may email Salma Warshanna-Sparklin at swarsha3@jhu.edu.

Advocacy Toolkit Spotlight

Advocacy for Immunization aims to help you find ideas, resources, and guidance to advocate for strengthened commitment to vaccines and immunization to save lives.

The tool guides you through detailed steps to get started with advocacy planning, and provides tips and guidance about how to improve efforts for greater impact.

Introduction Updates

Nigeria, one of the countries with the highest rotavirus mortality rates, received approval from Gavi for the rotavirus vaccine introduction plan. Phase 1 is slated to begin January 2018 and Phase 2 in July 2018. In addition, Pakistan was approved by Gavi to introduce rotavirus vaccine, starting in one province later this year and nationwide in 2017.
 
A full list of countries that have introduced rotavirus vaccines is available on the ROTA Council website.

Rotavirus in the Media

Public health: Rotavirus vaccine to help fight diarrhoea. The Express Tribune. 23 July 2016
 
Diarrhoea cases drop. The Fiji Times. 3 July 2016.
 
Vaccines to keep diseases at bay. The Star. 23 July 2016.
 
Medical Speak: Separating vaccine facts from fiction. Freemalaysiatoday.com. 20 July 2016.
 
Government advised to include rotavirus vaccine in national schedule. Myanmar Times. 22 June 2016.
 
Reaching every child in Africa with rotavirus vaccines: A historic event at a historic time. DefeatDD Blog. 8 June 2016.
 
Viruses may trigger pathological false alarm in the intestine. MedicalXPress. 20 June 2016.
 
Free vaccinations against hepatitis and rotavirus. VLT.se. 23 June 2016.
 
Bringing rotavirus vaccines to Bangladesh. Global Health Insights. 2 May 2016.
 
Gaps in vaccine coverage highlighted with new report and online tool. MedicalXPress. 24 May 2016.
 
Money for vaccination project major concern. Asian Age. 6 May 2016.
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