a Department of Paediatrics , The Chinese University of Hong Kong , Hong Kong S.A.R.
b Department of International Health , Johns Hopkins University , Baltimore , Maryland , United States.
Hum Vaccin Immunother. 2018;14(9):2281-2296. doi: 10.1080/21645515.2018.1470725. Epub 2018 Jun 18.
An estimated 215,000 children died of rotavirus infections in 2013, accounting for 37% of diarrhea-related deaths worldwide, 92% of which occurred in low and lower-middle income countries. Since 2009 the World Health Organization (WHO) recommends the use of rotavirus vaccines in all national immunization programs. This review compares rotavirus vaccine (RV) introductions and vaccine coverage by region, country income status and Gavi-eligibility from 2006-2016. Gross National Income data from the World Bank and surviving infant population from United Nations Population Division was obtained for 2016. Data from WHO were collected on rotavirus vaccine coverage, national immunization schedules, and new vaccine introductions for 2016 while estimated rotavirus deaths were collected for 2013, the last year of available WHO data. As of December 2016, the majority of countries (57%, 110/194) had not introduced universal rotavirus vaccine despite WHO's 2009 recommendation to do so. Countries in the WHO African region had the greatest proportion of introductions (37%, 31/84) by December 2016 and a great majority of these (77%, 24/31) were supported by new vaccine introduction (NVI) grants from Gavi. Almost half (48%) of global introductions were in low and lower-middle income Gavi-eligible and Gavi-graduating countries. Conversely, countries in the Southeast Asia WHO region and those not eligible for Gavi NVI support have been slow to introduce rotavirus vaccine. High-income countries, on average, had poorer rotavirus vaccine coverage compared to low and lower-middle income countries. The over-representation of African countries within the Gavi subset and high estimated rotavirus deaths in these African countries, likely explains why introduction efforts have been focused in this region. While much progress has been made with the integration and implementation of rotavirus vaccine into national immunization programs, 110 countries representing 69% of the global birth cohort had yet to introduce the vaccine by December 2016.
据估计，2013 年有 21.5 万名儿童死于轮状病毒感染，占全球腹泻相关死亡人数的 37%，其中 92%发生在中低收入国家。自 2009 年以来，世界卫生组织（WHO）建议所有国家免疫规划使用轮状病毒疫苗。本综述比较了 2006 年至 2016 年按区域、国家收入状况和 Gavi 资格进行的轮状病毒疫苗（RV）引入和疫苗覆盖率。2016 年从世界银行获取了国民总收入数据，从联合国人口司获取了存活婴儿人口数据。2016 年从世卫组织收集了轮状病毒疫苗覆盖率、国家免疫计划和新疫苗引进的数据，同时收集了 2013 年（可获得世卫组织数据的最后一年）估计的轮状病毒死亡人数。截至 2016 年 12 月，尽管世卫组织 2009 年建议普遍使用轮状病毒疫苗，但大多数国家（57%，110/194）尚未引入。截至 2016 年 12 月，世卫组织非洲区域的国家开展轮状病毒疫苗引进的比例最大（37%，31/84），其中大多数（77%，24/31）得到 Gavi 新疫苗引进赠款的支持。全球约一半（48%）的引进工作在中低收入国家和 Gavi 资格国家以及 Gavi 毕业国家中进行。相反，东南亚世卫组织区域的国家和没有资格获得 Gavi NVI 支持的国家推出轮状病毒疫苗的速度较慢。高收入国家的轮状病毒疫苗覆盖率平均低于中低收入国家。非洲国家在世卫组织分类中所占比例过高，这些非洲国家估计的轮状病毒死亡人数过高，这可能解释了为什么轮状病毒疫苗引进工作主要集中在该区域。虽然在将轮状病毒疫苗纳入国家免疫规划方面取得了很大进展，但到 2016 年 12 月，仍有 110 个国家（占全球出生队列的 69%）尚未引入该疫苗。
