Evaluation of rotavirus vaccines in Asia--are there lessons to be learnt?

Rotavirus mortality is highest in the Asia-Pacific region and rotavirus vaccines could have enormous impact here. Yet, live-attenuated orally administered rotavirus vaccines have been evaluated in a small number of immunogenicity studies in some Asian countries, where the immune responses have been documented to be moderate in low-income countries with high diarrhoeal disease burden and mortality, and high in middle-/high-income countries with little reported rotavirus deaths. This review of these rotavirus clinical trials examines the results observed and attempts to draw lessons to inform decision-making, aid design of additional clinical trials and guide vaccine development by local manufacturers.