Alternative approaches to live attenuated oral rotavirus vaccines

Oral attenuated rotavirus vaccine is safe and effective in developed countries but, however, it is less effective in low income countries such as African and Asian countries. Low vaccine effectiveness in low-income countries is arising from a variety of sources such as maternal antibodies, chronic enteropathy and other enteric diseases such as cholera, typhoid, and parasitic diseases, as well as the microbiota. There is increasingly evidence related to the risk of intussusception for the oral vaccine. The development of effective and safer rotavirus vaccines, particularly, non-living candidates, is critical. The aim of this review therefore is to explore some of the effective rotavirus vaccine alternatives to live attenuated oral virus vaccines. It primarily reveals non-living candidates such as inactive rotavirus vaccines, rotavirus-like particles, recombinant subunit proteins and non-living mucosal rotavirus vaccines. These approaches have been tested in a variety of animal models with great success in eliciting powerful immune responses. It is high time now for various vaccine manufacturers to look at these tested approaches, as they will provide hope to low-income countries in terms of producing vaccines that are both safe and effective.