Yen Catherine, Healy Kelly, Tate Jacqueline E, Parashar Umesh D, Bines Julie, Neuzil Kathleen, Santosham Mathuram, Steele A Duncan
a Division of Viral Diseases, Centers for Disease Control and Prevention , Atlanta , GA , USA.
b Johns Hopkins University Bloomberg School of Public Health , Baltimore , MD , USA.
Hum Vaccin Immunother. 2016 Oct 2;12(10):2580-2589. doi: 10.1080/21645515.2016.1197452. Epub 2016 Jun 20.
As of January 2016, 80 countries have introduced rotavirus vaccines into their national immunization programs. Many have documented significant declines in rotavirus-specific and all-cause diarrheal illnesses following vaccine introduction. Two globally licensed rotavirus vaccines have been associated with a low risk of intussusception in several studies. In July 2014, the Rotavirus Organization of Technical Allies Council convened a meeting of research and advocacy organizations, public health experts, funders, and vaccine manufacturers to discuss post-marketing intussusception surveillance and rotavirus vaccine impact data. Meeting objectives were to evaluate updated data, identify and prioritize research gaps, discuss best practices for intussusception monitoring in lower-income settings and risk communication, and provide insight to country-level stakeholders on best practices for intussusception monitoring and communication. Meeting participants agreed with statements from expert bodies that the benefits of vaccination with currently available rotavirus vaccines outweigh the low risk of vaccination-associated intussusception. However, further research is needed to better understand the relationship of intussusception to wild-type rotavirus and rotavirus vaccines and delineate potential etiologies and mechanisms of intussusception. Additionally, evidence from research and post-licensure evaluations should be presented with evidence of the benefits of vaccination to best inform policymakers deciding on vaccine introduction or vaccination program sustainability.
截至2016年1月，已有80个国家将轮状病毒疫苗纳入其国家免疫规划。许多国家记录了在引入疫苗后轮状病毒特异性腹泻疾病和所有原因引起的腹泻疾病显著下降。在几项研究中，两种全球许可的轮状病毒疫苗与肠套叠的低风险相关。2014年7月，轮状病毒技术联盟理事会组织召开了一次会议，研究和宣传组织、公共卫生专家、资助者及疫苗制造商参加了此次会议，会议讨论了疫苗上市后肠套叠监测和轮状病毒疫苗影响数据。会议目标是评估最新数据、确定研究差距并按优先顺序排列、讨论低收入环境中肠套叠监测和风险沟通的最佳做法，并向国家层面的利益相关者提供肠套叠监测和沟通最佳做法的见解。与会者同意专家机构的观点，即目前可用的轮状病毒疫苗接种的益处大于接种相关肠套叠的低风险。然而，需要进一步研究以更好地了解肠套叠与野生型轮状病毒和轮状病毒疫苗之间的关系，并阐明肠套叠的潜在病因和机制。此外，研究和上市后评估的证据应与疫苗接种益处的证据一起呈现，以便为决定引入疫苗或疫苗接种计划可持续性的政策制定者提供最佳信息。
