The vaccine efficacy observed Selumetinib mw during this outbreak would suggest that the outbreak was
not caused by a vaccine escape strain. However, continued strain surveillance is required to understand the impact of vaccine introduction. The Australian Rotavirus Surveillance program is supported by grants from the Australian Commonwealth Department of Health and Aging, GSK Biologicals (Melbourne, Australia) and CSL (Melbourne, Australia). This study was supported by the Victorian Government’s Operational Infrastructure Support Program. CD Kirkwood is supported by a Career Development Award from the National Health and Medical Research Council of Australia (607347). Conflicts of interest: No conflicts of interest were declared in relation to this article. “
“The introduction of rotavirus vaccines, provided in infancy, should have a major impact on rotavirus gastroenteritis (RVGE) among
developing country populations in Africa and Asia ; 5% of all-cause under-5 child mortality and up to 36% of under-5 gastroenteritis hospitalizations across the globe could be prevented by using rotavirus vaccines , ,  and . Recently published results from three developing country trials testing the efficacy of the two World Health Organization (WHO) pre-qualified rotavirus vaccines (human rotavirus vaccine [HRV] and pentavalent rotavirus vaccine [PRV]) PCI-32765 demonstrated that, although efficacy estimates were lower than for developed countries, the absolute reduction in RVGE incidence due to these vaccines in these populations was substantial ,  and . While not designed for such an analysis, the results of these clinical trials suggested a trend towards increasing efficacy with increasing episode severity , ,  and . The results of these studies informed the WHO recommendation to include rotavirus vaccines in the national immunization programs of all countries . Phase II and Phase III trials are currently
underway or being planned to evaluate new rotavirus vaccine candidates Ketanserin . Moreover, following vaccine introduction into countries, post marketing surveillance studies can help monitor the effectiveness of routine vaccine use , ,  and . For developing countries, the main outcome of public health interest will be severe RVGE, in addition to safety , , ,  and . Thus, for optimal study design and interpretation, as well as in potential future studies examining the benefits of therapeutic interventions like probiotics , it is important to improve understanding of how rotavirus clinical severity scoring systems used for measuring RVGE severity compare and perform in diverse settings.