These recommendations are based on the assumption that the current Jennerian vaccines are effective. When the data from the Venezuelan trial are available, these objectives should be reviewed.
Vaccine-related work in humans:
Evaluate and optimize ways to boost the immunogenicity of vaccine candidates:
- Evaluate oral/oral, parenteral/oral or oral/parenteral combinations
- Evaluate neonatal priming.
Suggested candidates and combinations to be tested:
- Sequential administration of two different Jennerian vaccines (i.e., a rhesus rotavirus-based vaccine followed or proceeded by a bovine rotavirus-based Jennerian vaccine).
- Jennerian vaccine followed or proceeded by an inactivated vaccine.
- Jennerian vaccine followed or proceeded by a virus-like particle (VLP) vaccine.
- Jennerian vaccine followed or proceeded by an attenuated human rotavirus vaccine.
- Phase 1 trial of micro-encapsulated vaccine.
- Phase 1 trials of non-living vaccine candidates such as VLPs and inactivated virus.
- Other ideas to boost immunogenicity, especially local immunity.
Vaccine evaluation of Jennerian vaccine in advanced stages of development in diverse geographical regions (Latin America, Asia and Africa):
- Settings to include areas with diverse and unusual rotavirus sero-types, year-round versus seasonal disease and high versus low diarrhoeal prevalence.
- Endeavour to administer vaccine with routine childhood immunization (EPI).
- Placebo controlled catchment studies to include follow-up by passive surveillance or clinic visits or hospitalized cases. Subset of study designed to permit assessment of mechanisms of vaccine failures.
- Epidemiology studies might be considered if they set the stage for planned rotavirus vaccine trials.
- Further research on correlates of protection in humans. Emphasis on use and optimization of methods to detect intestinal antibody responses.
Vaccine-related work in animals:
Emphasis on the porcine animal model of diarrhoeal disease:
- Validate model further by testing Jennerian vaccine concept.
- Evaluate VLPs and inactivated virus vaccines.
Other new vaccine approaches to enhance immunogenicity.