PROSPECTS FOR VACCINES AGAINST ROTAVIRUSES

Candidate vaccines against rotavirus-caused diarrhoea have been under development for more than ten years. Recent research has helped to ide ntify virological and immunological parameters which are most likely t o be correlates of protection from rotavirus infection and disease. La rge double-blind, placebo-controlled trials in the United States and V enezuela have resulted in successful protection from severe disease an d dehydration after immunisation with live-attenuated rhesus rotavirus -based monovalent and tetravalent vaccine candidates. The tetravalent vaccine is now submitted for regulatory approval in the United States. The anticipated widespread use of such a vaccine will need careful sa fety and effectiveness surveillance as the enormous diversity of rotav irus antigenicity may affect efficacy in different geographical region s. To proceed from licensure to reduction of disease a series of goals must be achieved: the vaccine must be recommended by major immunisati on advisory committees, be financed in both the public and private sec tors, be integrated into existing vaccination schedules, be promoted, find parental acceptance and achieve a high level of coverage. (C) 199 8 John Wiley & Sons, Ltd.