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Polio endgame: Lessons for the global rotavirus vaccination program

机译：Polio Endgame：全球轮状病毒疫苗接种计划的课程

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Poliovirus and rotavirus share notable similarities. Although rotavirus is not amenable to eradication because of animal reservoirs, live, attenuated oral vaccines have been the bedrock of both prevention and control programs, providing intestinal and humoral immunity. Both programs have also encountered safety concerns and suboptimal immune responses to oral vaccines in low-income settings that have been challenges, prompting the search for alternative solutions. In this paper, we review the progress made by polio prevention and eradication efforts over the past six decades. Specifically, we discuss the roles of the oral polio vaccine (OPV) and the inactivated polio vaccine (IPV) in achieving polio eradication, and explore potential application of these lessons to rotavirus. Recent scientific evidence has confirmed that a combined schedule of IPV and OPV adds synergistic value that may give the polio eradication effort the tools to end all poliovirus circulation worldwide. For rotavirus, oral vaccine is the only currently licensed and recommended vaccine for use in all children worldwide, providing heterologous protection against a broad range of strains. However, parenteral rotavirus vaccines are in the pre-clinical and clinical trial stage and insight from polio provides strong justification for accelerating the development of these vaccines. While challenges for parenteral rotavirus vaccines will need to be addressed, such as achieving protection against a broad range of strains, the principle of combined use of oral and parenteral rotavirus vaccines may provide the necessary humoral and intestinal immunity necessary to close the efficacy gaps between developing and developed countries, therefore controlling rotavirus worldwide. This strategy may also potentially reduce risk of intussusception. Published by Elsevier Ltd.
机译：Poliovirus和RotaVirus共享着名的相似之处。虽然RotaVirus由于动物储层而不是侵蚀，但由于动物储层，活化，减毒的口腔疫苗是预防和控制程序的基岩，提供肠道和体液疫苗。两种程序也遇到了对挑战的低收入环境中的口腔疫苗的安全问题和次优的免疫应答，提示寻找替代解决方案。在本文中，我们审查了过去六十年来Polio预防和消除努力所取得的进展。具体而言，我们讨论口服脊髓灰质炎疫苗（OPV）和灭活的脊髓灰质炎（IPV）在实现脊髓灰质炎灭绝方面的作用，并探讨这些课程对轮状病毒的潜在应用。最近的科学证据证实，IPV和OPV的综合时间表增加了协同价值，可能会使POLIO消除努力成为全世界所有Poliovirus流通的工具。对于RotaVirus，口腔疫苗是全球所有儿童使用的目前唯一的许可和推荐疫苗，可防止抗菌株广泛的菌株。然而，肠胃外轮状病毒疫苗在临床前和临床试验阶段，脊髓灰质炎的洞察力为加速这些疫苗的发展提供了强大的理由。虽然需要解决肠胃外轮状病毒疫苗的挑战，例如实现对广泛菌株的保护，但组合使用口服和肠胃外轮状病毒疫苗的原则可以提供缩小发展之间的功效差距所需的必要的体液和肠梗阻。和发达国家，因此控制着全球轮状病气。这种策略也可能降低肠套化风险。 elsevier有限公司出版

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