Group A rotavirus universal mass vaccination: how and to what extent will selective pressure influence prevalence of rotavirus genotypes?

Abstract

Two human group A rotavirus (RVA) vaccines are available and highly effective in preventing severe gastroenteritis caused by all commonly circulating human RVA genotypes. The effect of universal mass vaccination on the RVA genotype distribution is discussed based on the knowledge of complete RVA genotype constellations, data from clinical efficacy trials and effectiveness studies, and genotype surveillance data from countries with universal mass vaccination programs. The theoretically predicted relative enrichment of RVA strains with the G2P[4] DS-1-like genotype constellation in regions with high coverage by Rotarix^® (GlaxoSmithKline Biologicals, Rixensart, Belgium) seems to become apparent. A G3P[8] genotype increase, which was noted in several regions with a high coverage of RotaTeq^® (Merck and Co., Inc., NJ, USA), is more difficult to explain based on the theoretical considerations.

Keywords::

• G2P[4]
• G3P[8]
• genotype
• relative enrichment
• Rotarix^®
• RotaTeq^®
• rotavirus
• selective pressure
• vaccine

Financial & competing interests disclosure

J Matthijnssens was supported by a ‘Fonds voor Wetenschappelijk Onderzoek’ postdoctoral fellowship. CD Kirkwood was supported by a National Health and Medical Research Council CDA fellowship (609347). J Matthijnssens and M Van Ranst were investigators in a postmarketing effectiveness study conducted in Belgium and sponsored by GlaxoSmithKline Biologicals. C Kirkwood is Director of the Australian Rotavirus Surveillance Program, which is supported by research grants from GlaxoSmithKline Biologicals and CSL. M Ciarlet was employed at Merck and Co., Inc. when the pivotal rotavirus efficacy and postmarketing effectiveness studies were performed, and owned stock in the company. U Desselberger was a member of the GSK-supported PROTECT group, which was dissolved in 2010. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.