Therefore, to assist in the rapid establishment or strengthening of functional, sustainable independent NITAGs, and to benefit from the experience of the most advanced committees, the WHO is working through its regional and country

offices and with partners to support countries with the following activities: • Providing more specific regional guidance documents and facilitation of access to framework documents such as standard declarations of interest. Among key WHO partners taking part in the direct support to countries are the US Centers for Disease Control BLZ945 and Prevention, the ProVac Initiative, launched in 2006 to provide technical cooperation and strengthen national capacity to make evidence-based, informed decisions in the context of the introduction of new and underutilized vaccines [32],

and the more recent SIVAC (Supporting Independent Immunization and Vaccine Advisory Committees) Initiative [48]. The objective of this latter Initiative is to assist in the establishment or strengthening of functional, sustainable independent NITAGs in GAVI-eligible and middle income countries in making recommendations for program improvements and vaccine introductions through technical assistance, training, CT99021 development of tools and information sharing. More information and link to these resources can be found at: http://www.who.int/immunization/sage/national_advisory_committees/en/index.html. Philippe Duclos has no financial interests relevant to this paper. To Lara Wolfson who contributed to the development of the initial guidance document. To Abdoul-Reza Esteghamati, Ministry of Health and Medical Education, Teheran; Steve Landry, Bill and Melinda Gates Foundation; Noni MacDonald, Dalhousie University; Bjorn Melgaard; and Jean Smith US Centers for Disease Control and Prevention who reviewed and provided insight on the initial guidance document. With particular thanks to Noni MacDonald and Jean Smith for their review of this paper and useful comments. To Lara

Gautier, Julia Blau, and Kamel Senouci from the Agence de Médecine Préventive who have reviewed this manuscript and provided useful comments and their help with the literature review and practical insight. Ketanserin All colleagues from WHO regional offices who have been involved with the NITAG strengthening at country level and particularly Nahad Sadr-Azodi and Niyazi Cakmak for their useful insight on the guidance document and sharing of practical experience. “
“The need for evidence-based decision making in immunization programs has become crucial in light of multiple health priorities, limited human resources and logistical capacities, as well as the high cost of vaccines relative to limited public funds that are available.

While it was reported that there was no statistically significant difference in vaccine efficacy against G1 and non-G1 genotypes selleck chemicals llc in the clinical trial [8], we considered it important to

examine whether the strain variation observed for the two surface protein genes extended to the other genome segments. Of note, there is a considerable lack of overall genomic RNA homology between human rotavirus strains with long RNA patterns (as represented by the Wa strain; hence called the Wa genogroup to which RIX4414 belongs), and human rotavirus strains with short RNA patterns (as represented by the DS-1 strain; hence called the DS-1 genogroup to which strains including genotype G2P[4] belong) [18], [19] and [20]. The aim of this study was to compare by RNA–RNA hybridization the whole genomic RNA constellation of circulating wild-type rotaviruses detected during the clinical trial in Malawi with RIX4414 (the strain contained in Rotarix™). This study also aimed to determine the nucleotide sequence similarities between RIX4414

and circulating wild-type rotaviruses in Malawi, as compared with RIX4414 and other globally circulating strains, in the genome segments coding for the neutralisation proteins Selleckchem Doxorubicin VP7 (G genotype) and VP4 (P genotype), the middle capsid protein (VP6: I genotype), and the viral enterotoxin (NSP4: E genotype). Rotavirus-positive specimens (N = 147) collected from vaccine and placebo recipients in the clinical trial in Blantyre, Malawi, were previously examined for G and P types at DDL Diagnostic Laboratory (Voorburg, Mannose-binding protein-associated serine protease the Netherlands) by a testing algorithm using RT-PCR followed by a reverse hybridization assay [21]. Of those, only specimens containing a minimum volume of 500 μl as 10% suspension in Earl’s Balanced Salt Solution (N = 88) were utilized in this study. Rotavirus specimens examined comprised G12P[6] (N = 25),

G8P[4] (N = 28), G1P[8] (N = 11), G9P[8] (N = 9), G12P[8] (N = 5), G2P[4] (N = 3), G8P[8] (N = 2), G12P[4] (N = 1), G1P[6] (N = 1), G8P[6] (N = 1), G12P[6]/P[8] (N = 1) and G8P[4]/P[6] (N = 1). The vaccine strain (RIX4414) used in this study was recovered following inoculation into MA104 cell culture of a portion of the Rotarix™ commercial vaccine. Rotavirus RNA was extracted using an RNAeasy kit (Qiagen Ltd., Sussex, UK) according to the manufacturer’s instructions, and separated by electrophoresis on a 10% polyacrylamide gel followed by staining with silver nitrate as described previously [22]. Electropherotypes were assigned for those strains that showed 11 segments of double-stranded (ds) RNA, and were determined by comparison of the individual RNA migration patterns of genome segments on the gel.