Rota virus vaccine

Pedagogy lecture on rotavirus vaccines

1. By: Dr. Swati Shikha JR Dept. of PSM ROTA VIRUS VACCINE Venue: Seminar Hall Duration: 10 min

2. Learning Objectives: Introduction about Rotavirus disease: Problem Statement Epidemiology a) Agent Factor b) Host c) Transmission Prevention Rotavirus Vaccine : Types RVV in India (Dosage and administration) Storage Estimation of vaccine requirement 2

3. INTRODUCTION Rotavirus was 1 st discovered in 1973 Is the leading cause of severe dehydrating diarrhea in children <5 years of age, globally. Problem Statement: Globally: causes 3.4% of all under 5 deaths 37% of total diarrheal deaths and 40% of total diarrhea related hospitalizations. India: 22% of worldwide rotavirus deaths. - Highest burden in India. 3

4. AGENT: ROTAVIRUS DISEASE Caused by : Rotavirus Is a double stranded RNA virus Family: Reoviridae Is wheel-shaped under electron microscope, hence called Rotavirus. 9 species- A,B,C,D,E,F,G,H,I. Most common- Rotavirus A 4

5. HOST FACTOR Children <5 years of age are affected 1 st episode of the disease Developing countries Developed countries at <12 months of age 2-5 years of age Severe form of the disease is limited to children aged 6-24 months. Rotavirus reinfection is common. 5

6. MODE OF TRANSMISSION Fecal-oral route: Person to person or via fomites During 1 st episode of infection, viruses are shed for several days in a very high concentration ( >10 12 particles/ gram ) in stool and vomitus . Incubation period: 1-3 days Vomiting Diarrhea Resolves in 3-7 days Electrolyte imbalance & Shock Death 6

7. PREVENTION: ROTAVIRUS VACCINE 4 types of RVV is available in Indian market: Rotasil (RV5): Live attenuated oral freeze dried Diluent : Citrate bicarbonate buffer Contains- G1,G2,G3,G4,G9 serotypes 3 doses- at 6,10,14 weeks Rotavac (ORV116E): Liquid vaccine Contains- 116E (G9P[11]) Derived from neonatal strains isolated in India 3 doses: 6,10,14 weeks 7

8. Cont…. Rotarix (RV1) : Liquid vaccine Contains G1P(8) serotype 2 doses: 2 and 4 months Rotateq (RV5): Liquid vaccine Contains G1,G2,G3,G4 or P1A(8) 3 doses: 2, 4, and 6 months Efficacy of RVV against severe rotavirus diarrhea in India = 40-60% 8

9. As per recommendation of NTAGI,(MOHFW, GOI) Introduce RVV in UIP in a phased manner, in India An oral liquid RVV has been successfully introduced in 9 states – Haryana, Himachal Pradesh, Andra Pradesh, Madhya Pradesh, Odisha , Assam, Rajasthan, Tripura, Tamil Nadu Currently, a new type of RVV is being introduced Live attenuated oral freeze dried vaccine Diluent : Citrate bicarbonate Becomes pinkish after reconstitution 9

10. Cont.. Available in vials containing 2 doses each (5ml) 1 dose = 2.5 ml = 5 drops (1 drop = 0.5 ml) Administered via 6 ml oral syringe ( do not inject) Vaccine is to be supplied free of cost by GOI 1 Vial is supplied along with - diluent vial - Adapter - 6ml oral syringe Reconstituted vaccine can be used upto 4hours Schedule: 6 wks, 10 wks, 14 wks Dose: 2.5 ml(5 drops) Route: oral, through syringe towards inner cheek. No booster required 10

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12. STORAGE At 2 – 8 degree Celsius at all levels in cold chain In ILR, it should be stored at or above BCG Syringe and adapter is stored at room temperature It has VVM type 30. 12

13. RVV stock management ( Inventory Control) EEFO ( Early Expiry, First Out) Reuse of Reconstituted Vaccine Partially used vaccine vials returned from session site are to be kept separately in ILR for atleast 48 hours or till the next session . 13

14. Phasing In: Upper age for giving RVV 1 st dose is 1 year Subsequent 2 or more dose to be given at an interval of atleast 4 weeks Vaccine provides protection for 1 st 2 years of life. CONTRA- INDICATIONS: Allergic reaction H/o documented intussusception or abdominal surgery Immunodeficiency. 14

15. ESTIMATION OF VACCINE REQUIREMENT Annual vaccine requirement (in dose): = no. of beneficiaries X no. of doses per infant X 1.11 X 1.25 {wastage multiplication factor = 1.11} No. of vials needed = no. of vaccine dose no. of dose in the vial(2) Wastage rate = ( Dose issued – Dose administered ) X 100 Dose issued 15

16. THANK YOU PROTECT THE CHILD FROM ROTAVIRUS DISEASE 16