Division of Pediatric Infectious Diseases, Department of Pediatrics, Hasbro Children's Hospital, The Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Curr Opin Pediatr. 2012 Feb;24(1):76-84. doi: 10.1097/MOP.0b013e32834ee594.
Rotavirus infection is the most common cause of severe diarrhea disease in infants and young children worldwide and continues to have a major global impact on childhood morbidity and mortality. Two effective rotavirus vaccines are available and recommended for routine immunization of all infants. These vaccines have been introduced in both developed and developing countries. As rotavirus vaccines are implemented, studies have been undertaken that assess the effects of vaccination on rotavirus disease in children. This review summarizes the results of these studies.
Studies that assess health impact, indirect benefits, and strain changes after the introduction of rotavirus vaccine have been reported. In industrialized countries, rotavirus vaccination has led to dramatic drops in severe rotavirus-related hospitalizations and has reduced emergency room visits. Data from clinical trials in developing counties in Asia and Africa have demonstrated that rotavirus vaccines significantly reduce severe diarrhea episodes due to rotavirus. Herd (community) immunity has also been noted after routine rotavirus immunization in several countries. There have been no significant strain shifts or escape mutants noted since the introduction of rotavirus vaccines.
Two well tolerated and effective rotavirus vaccines have reduced the health burden of rotavirus gastroenteritis in both developed and developing countries.
轮状病毒感染是全世界婴幼儿严重腹泻病的最常见病因,并且仍然对儿童发病率和死亡率造成重大的全球性影响。两种有效的轮状病毒疫苗已被开发出来并推荐用于所有婴儿的常规免疫接种。这些疫苗已在发达国家和发展中国家推出。随着轮状病毒疫苗的实施,已经进行了评估疫苗接种对儿童轮状病毒病影响的研究。本综述总结了这些研究的结果。
已经报告了评估疫苗接种后的健康影响、间接效益和病毒株变化的研究。在发达国家,轮状病毒疫苗接种导致严重轮状病毒相关住院率大幅下降,并减少了急诊就诊。来自亚洲和非洲发展中国家临床试验的数据表明,轮状病毒疫苗显著减少了轮状病毒引起的严重腹泻发作。在几个国家进行常规轮状病毒免疫接种后,也观察到了群体(社区)免疫力。自轮状病毒疫苗问世以来,尚未发现明显的病毒株转变或逃逸突变。
两种耐受性良好且有效的轮状病毒疫苗已降低了发达国家和发展中国家轮状病毒肠胃炎的健康负担。