However, the benefits of rotavirus

vaccination against severe diarrhea and death from rotavirus infection far exceed the miniscule risk of intussusceptions. It urges the manufacturers to actively monitor the risk of intussusceptions as the usage of these vaccines is bound to go up. This will also require strengthening of AEFI surveillance in the country. Information about the possible risk of intussusceptions associated with rotavirus vaccination needs to be communicated clearly to the national decision-makers, healthcare providers, and parents. The committee also stresses the need of strictly adhering to the set upper age limits of these vaccines, i.e. the first dose of either RV1 or RV5 should be administered between AG-014699 concentration the ages of 6 weeks and 14 weeks and 6 days, and that the maximum age for administering the last dose of Selumetinib either vaccine should be 32 weeks25 of these vaccines while prescribing them in office practice. The committee has recommended inclusion of the history of intussusception in the past as an absolute

contraindication for rotavirus vaccine (RV1 and RV5) administration. The committee studied the recent data on PCV13 and PCV10. The committee also reviewed the reports of PCV13 studies done worldwide on immune responses (IgG – GMC, OPA – GMT) and boostability for the serotype 3 capsular antigen,26 and the immune responses following post-primary and post-booster series against serotype 19A infections, with PCV10 and PCV13.27 and 28 It has reviewed the interim data of COMPAS trial done in three Latin American countries with PCV1029 and effectiveness of PCV10 in Brazil.30

The committee also reviewed available data on the efficacy of the new serotypes in the PCV13. In England and Wales,31 vaccine effectiveness (VE) for the new serotypes for 2 doses under a year was 78% (95% CI: −18 to 96%) and 77% (CI: 38–91%) for Interleukin-2 receptor one dose over a year. VE for 7F and 19A was 76% (CI: 21–93%) and 70% (CI: 10–90%), respectively for ≥ one dose, for serotypes 1 and 3 was 62% and 66%, respectively although confidence intervals spanned zero. IPD due to PCV13-only serotypes halved in children under 2 years in the study period.31 The committee believes that the direct protection rendered by the serotype included in a vaccine formulation is definitely superior to any cross protection offered by the unrelated serotypes even of the same group in a PCV formulation. However, the committee still not convinced about the clinical efficacy of serotype 3 contained in PCV13 despite multiple studies showing good functional immune responses after the infant series29 and reasonably good effectiveness.31 There has been no consistent PCV13 impact on serotype 3 IPD or carriage reported so far.