Talk:Rotavirus vaccine

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 18 August 2020 and 4 December 2020. Further details are available on the course page. Student editor(s): Lopcal. Peer reviewers: Aced 24, Jnashl24.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 08:23, 17 January 2022 (UTC)

Recent Edits

I have reverted the recent, well-intentioned changes to the article's title and main subject. I created this article to complement Rotavirus and intend to build the article up as the Program gathers speed. Unfortunately, the name change was not discussed and links to the article were not checked.

Given the contents of the article it seemed like such an obvious move that it didn't seem likely anyone would object, but since there is question, I have opened a formal proposal and invitation for discussion below.

I did check the links to the article after the move, there were only a few double redirects, and they seemed pretty minor (from people's talk pages, etc.) Figured the bot could handle them. I also fixed what I figured would be the most common link (the one on template:vaccines). Zodon (talk) 07:15, 8 August 2008 (UTC)

Requested move

Suggest moving this article from Rotavirus Vaccine Program to Rotavirus vaccine

It seems like it would make sense to move this article to the more general topic of Rotavirus vaccine (which is currently a redirect to this article).

• Presently most of this article is about Rotavirus vaccines in general, only one paragraph deals with the Rotavirus Vaccine Program.
• Other articles are using this article as a surrogate for a Rotavirus vaccine article (e.g. Template:Vaccines ).

When the section of this article on the Rotavirus Vaccine Program becomes large enough, it could be split off into its own article. Or, if it is desirable to have a separate article on the Vaccine Program now, it seems more appropriate to move most of the current content of this article to one on Rotavirus Vaccine. (For instance, if this article is about the Vaccine Program, then History should be the history of the program, not the history of Rotavirus vaccines, as it is now.) However, rather than having lots of little articles, I think it would be better to keep it together and move to more general topic, let it grow, then split when needed. Thanks. Zodon (talk) 07:04, 8 August 2008 (UTC)

There being no further discussion, an administrator made the move. I have rearranged the header here, and made appropriate revisions to links on Rotavirus and the template:vaccines. Zodon (talk) 17:57, 14 August 2008 (UTC)

Effectiveness

This section doesn't actually report on the clinical effectiveness of the Rotavirus Vaccine.

"A 2009 review estimated that vaccination against rotavirus would prevent about 45% of deaths due to rotavirus gastroenteritis, or about 228,000 deaths annually worldwide."

Does that statement even make sense? Shouldn't that read "A 2009 review reported that WHOLESALE world-wide vaccination against rotavirus would prevent an estimated 45% of deaths due to rotavirus gastroenteritis."? —Preceding unsigned comment added by 118.210.198.85 (talk) 11:15, 8 June 2010 (UTC)

Countries using vaccine

This article should be updated to include the countries which are currently using the vaccine, and those that plan to. Thanks! — Preceding unsigned comment added by 203.152.114.160 (talk) 20:37, 19 February 2014 (UTC)

Bias fault regarding self-promotion.

Can anybody else see that? 70.74.164.9 (talk) 13:11, 4 February 2015 (UTC)

What is the issue? Its a recent review article? Doc James (talk · contribs · email) 13:18, 4 February 2015 (UTC)

All of the evidence in this review came through the manufacturer, so it involves a conflict of interest; *not* peer reviewed. 70.74.164.9 (talk) 17:12, 4 February 2015 (UTC)

The evidence did not come through the manufacturer. See Appendix I and II , in the paper, where the authors show their search criteria. Graham Beards (talk) 20:01, 4 February 2015 (UTC)

One of us cannot read an abstract. 70.74.164.9 (talk) 00:54, 6 February 2015 (UTC)

True. One person is reading "A systematic review of all publicly available data from RotaTeq™ vaccine-effectiveness and vaccination-impact studies in the USA, Europe and Australia" as "A systematic review of all publicly available data from RotaTeq™ vaccine-effectiveness and vaccination-impact studies in the USA, Europe and Australia". Abstracts are written in very terse language and can actually be pretty easy to misread. See Fig 1 on page 737. Guettarda (talk) 17:46, 7 February 2015 (UTC)

We are pretty clear here in discussing marketing scandals, drugs with serious side effects, and those with questionable efficacy. I think that when we run across one that by overwhelming acclaim is safe, effective, and brings substantial benefit to society, its ok to say that too. Formerly 98 (talk) 14:03, 4 February 2015 (UTC)

I would love to trust judgement from the Centers for Disease Control, too. In the case of rotavirus, though, somebody is saying that maternal antibodies interfere with a vaccination, so enable the vaccination to infect babies. 70.74.164.9 (talk) 18:09, 4 February 2015 (UTC)

They are not saying that at all. They are suggesting, based on the evidence from their study, that maternal antibodies in mothers' milk could inactivate the live attenuated rotavirus vaccine, rendering it less effective. They add that denying the children breast mike for a short time around the time of vaccination might improve the vaccine's efficacy. Graham Beards (talk) 19:56, 4 February 2015 (UTC)

Vaccines 101: Mammals are born with maternal antibodies, which are supplemented via nursing. Over time, these antibodies disappear, but no one knows exactly when it will happen for a particular subject.

As long as the newly born have maternal antibodies circulating in their systems, vaccinations will not stimulate the production of antibodies. But no one knows exactly when the antibodies will dissipate. That is why babies, puppies, etc. are vaccinated on a schedule, beginning before the earliest time the maternal antibodies are known to disappear, and ending after the latest time.50.0.36.90 (talk) 03:06, 4 June 2015 (UTC)

What is the difference between denying babies maternal antibodies from human milk and enabling infection? The attenuation process is an incomplete, chemically or heat driven process. There is always the risk of full infection. Why can't it wait until two years, when most of North America's babies are being completely weaned? 70.74.164.9 (talk) 00:54, 6 February 2015 (UTC)

What does that have to do with anything? We are not here to debate the merits of national or international vaccination policy. As for your original objection, sources are not required to be neutral or even unbiased, and a peer reviewed paper can be written by someone with tons of conflicts of interest – I'm sure anyone on this page can point you to several field-changing papers by people with significant COIs (published in anything from an open access journal to the New England Journal of Medicine). They are merely required to represent the position of their field (or a significant minority thereof). Would the source be stronger if it was not written by employees of Merck and Sanofi Pasteur? Sure. But is Human Vaccines a generally reliable, peer-reviewed journal? From what I can tell, yes. Please obtain consensus before removing this statement again. Thank you, NW (Talk) 00:29, 7 February 2015 (UTC)

I'm not sure I see any concrete proposals to improve the article here, just an editor mis-reading an abstract. Am I missing something? Guettarda (talk) 17:52, 7 February 2015 (UTC)

No, you are not missing anything. Graham Beards (talk) 18:00, 7 February 2015 (UTC)

History should start a bit earlier

History

In 1998, a rotavirus vaccine (RotaShield, by Wyeth) was licensed for use in the United States.

Did the gods bring this vaccine down from Mt. Olympus? Two sentences on the who and how of the development of this pioneering vaccine would not be out of place. Not that they should lead off the paragraph.50.0.36.90 (talk) 02:45, 4 June 2015 (UTC)

agree. although RotaShield withdrawn less than 1 year after release, but it still the first rotavirus vaccine and should be included in history section. Ckfasdf (talk) 12:30, 5 January 2020 (UTC)

Effectiveness

Not sure why the Cochrane review was removed?

"The vaccines prevent 15 to 34% of severe diarrhea in the developing world and 37 to 96% of severe diarrhea in the developed world."[1]

The text that replaced it was not based on as good of sources "The vaccines prevent 50 to 64% of severe rotavirus in the developing world[4] and 85 to 98% of severe rotavirus in the developed world.[5]"

The first ref is just quoting a couple of RCTs and was not a meta analysis of all avaliable trials.

The second ref is just for the first year of life [2] Doc James (talk · contribs · email) 09:43, 30 July 2016 (UTC)

About the disease

This IMO belongs on the rotavirus page "The vast majority of rotavirus deaths occur in the developing world, where access to treatment for severe diarrhea such as oral rehydration solution or intravenous fluids is often limited. Rotavirus is highly contagious and water quality, hygiene, and sanitation improvements do not prevent its spread;"

Doc James (talk · contribs · email) 09:55, 30 July 2016 (UTC)

Any vaccines for ADULTS? The article should mention, are there any or NOT?

ee1518 (talk) 14:18, 3 February 2018 (UTC)

Intussusception risk

Credible evidence exists that an increased risk for intussusception remains present in the more modern incarnations of the vaccine, though the risk is 10x lower than in the earlier versions. See the New England Journal of Medicine from Feb 6, 2014 titled Intussusception Risk after Rotavirus Vaccination in U.S. Infants which notes in conclusion that "The estimated risk associated with dose 1 of RV5 was about 1.5 excess cases per 100,000 recipients of the first dose of the vaccine, which was roughly one tenth the risk associated with the first-generation vaccine, Rotashield. The risks of intussusception must be considered in light of the demonstrated benefits of rotavirus vaccination."

Additionally, the current article states that with the older version of the vaccine there are increased risk "in babies who have had intussusecption" but this appears in accurate. Older versions had increased risk of causing infant intussusception (see the abstract of this 2008 study).

I suggest modifying the current article which reads "Older recommendations were to avoid rotavirus vaccination in babies who have had intussusception." and cites the WHO article from 2013, to "Older recommendations were to avoid rotavirus vaccination due to increased risk of infant intussusception.¹ An elevated risk remains of infant intussusception remains in the newer versions, but the risk is 10x lower (roughly 1.5 excess cases per 100,000 vaccinations).²" along with citation 1 to the 2008 study and citation 2 to the above referenced NEJM article.

I'm posting here first for two reasons - first to solicit any relevant feedback or contradictory studies that followed the 2014 paper. I haven't seen them but wanted to post here before editing. Second to solicit feedback on the phrasing proposed above - despite highlighting the increased risk, I want to avoid any suggestion that the vaccine is unsafe. The risk is low and is primarily important for awareness and treatment in the rare event of intussusception. I welcome feedback if there are better/clearer ways to simultaneously highlight the risk without seeming alarmist.

--Outsideshot (talk) 04:40, 25 February 2020 (UTC)

Grammatical clarity

I have no idea what this sentence is supposed to mean:

"Immunizing babies decreases rates of disease among older people and those who have not been immunized."

Does it purport that immunising babies decreases rates of disease among people who are older than the baby, or among the immunised babies themselves when they get old? Further, if we remove the reference to "older people" we are left with:

"Immunizing babies decreases rates of disease among those who have not been immunized"

That sounds like magic. Some clarification is needed. — Preceding unsigned comment added by Pontificateus (talk • contribs) 15:04, 6 December 2021 (UTC)

• Infectious diseases spread by infection.
• The likelihood of one specific person getting infected increases when more people carry the disease.
• If more people are protected from infection by immunzation, then fewer people carry the disease.
• Therefore, the more people are vaccinated, the lower is the likelihood of any specific person to get infected.
• So, immunizing people (babies or otherwise) protects everybody. That is why smallpox is extinct, and that is why anti-vaxxers hurt everybody.

It's not magic, it's logic and science. See also herd immunity. --Hob Gadling (talk) 06:59, 7 December 2021 (UTC)