Rotavirus aşıları Derleme

Rotavirüs tüm dünyada bebek ve küçük çocuklarda görülen ishallerin özellikle hastane yatışlarına ve bebek ölümlerine neden olan ağır gastroenteritin en önde gelen nedenidir Hemen tüm çocuklar beş yaşına kadar enfekte olurlar ve hastalık özellikle 4 36 ay grubunda dehidratasyon ve asidozla ağır seyrederek ölüme neden olabilir Rotavirüsler her yıl iki milyondan fazla hastane yatışına ve yaklaşık 600 bin ölüme sebep olmaktadır Rotavirüs ishalinin önlenmesinde tek yöntem rotavirüs aşılamasıdır İlk “reassortant” rotavirüs aşısı tetravalan maymun insan “reassortant” rotavirüs aşısı Rotashield ABD’de 1998’de lisans aldı ve aşı şemasına dahil edildi Ancak aşı ile invajinasyon arasında ilişki olduğu gerekçesiyle kısa bir süre içinde kullanımdan kaldırıldı Sonraki yıllarda iki yeni rotavirüs aşısının [monovalan human rotavirüs aşısı HRV Rotarix ve pentavalan human bovine reassortant rotavirüs aşısı PRV RotaTeq ] etkinliği ve güvenirliliği yaklaşık 130 000 bebekte yapılan geniş çalışmalarla değerlendirildi Bu çalışmaların sonuçları her iki yeni rotavirüs aşısının ishale özellikle ciddi ishale karşı etkin ve güvenli bir korunma sağladığını gösterdi Rotavirüs aşılarının rotavirüs olgularını 74 ağır olguları 98 ve hastane yatışlarını 96 azaltması beklenmektedir Rotavirüs aşıları ile invajinasyon riskinin artmadığı gösterilmiştir Günümüzde bu iki yeni rotavirüs aşısı ülkemizinde dahil olduğu 90’dan fazla ülkede lisans alarak kullanıma girmiştir ABD yanında Venezüella Brezilya Panama Meksika ve Avusturya gibi ülkelerde aşı takvimine dahil edilmiştir Aşı ağız yoluyla 2 ve 4 ayda olmak üzere iki dozda HRV için veya 2 4 ve 6 ayda olmak üzere üç dozda PRV için uygulanır İlk doz bebek 6 12 haftalık iken uygulanmalı ve aşılamaya 12 14 haftadan sonra başlanılmamalıdır ve aşılama 24 haftadan HRV için veya 32 haftadan önce HRV için tamamlanmalıdır Türk Ped Arş 2007; 42 Özel Sayı: 36 42 Anahtar kelimeler: Bebek “reassortant” rotavirüs aşıları rotavirüs

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Rotavirus vaccines Review

Rotavirus is a major cause of acute gastroenteritis worldwide and infects almost all children in the first 5 years of life with severe dehydrating gastroenteritis occurring primarily among children 4 to 36 months of age Rotavirus causes an estimated 600 000 deaths and more than 2 million hospitalizations each year A tetravalent rhesus human reassortant rotavirus vaccine Rotashield was licensed in 1998 for routine immunization of infants in the United States However the vaccine was subsequently withdrawn because of a likely association with intestinal intussusception Recently the efficacy and safety of two new rotavirus vaccines the monovalent human rotavirus vaccine HRV Rotarix and the pentavalent human bovine reassortant vaccine PRV RotaTeq was evaluated in large scale trials of more than 130 000 infants The two new rotavirus vaccines have shown good clinical efficacy in preventing rotavirus gastroenteritis especially severe disease These vaccines prevent about 74 percent of all rotavirus cases and about 98 percent of the most severe cases including 96 percent of rotavirus cases requiring hospitalization There was no association between the new rotavirus vaccines and increased risk of intussusception Today these two new rotavirus vaccines have been licensed in more than 90 countries and are used routinely in several countries such as USA Mexico Brazil Venezuela and Panama Vaccine doses should be administered at 2 and 4 months of age 2 doses for HRV or at 2 4 and 6 months 3 doses for PRV The first dose should be administered between 6 and 12 weeks of age; immunization should not be initiated for infants older than 12 weeks of age for PRV or 14 weeks of age for HRV All doses of vaccine should be administered by 24 weeks of age for HRV or 32 weeks of age for PRV Turk Arch Ped 2007; 42 Suppl: 36 42 Key words: Infant reassortant rotavirus vaccines rotavirus

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