Why does rotavirus vaccine effectiveness vary around the globe?

Maternal antibodies, gut health, co-infections, and genetics collectively limit rotavirus vaccine effectiveness in low- and middle-income countries.

• Why it matters: Vaccine effectiveness varies globally, with lower protection in LMICs where rotavirus mortality is highest, highlighting the need to understand underlying biological and environmental factors.
• What they did: The review analyzes how maternal antibody levels, gut microbiome disruption, co-infections, and genetic polymorphisms interact to impair vaccine replication and immunogenicity across different settings.
• The result: Addressing vaccine inequity may require tailored strategies combining optimized scheduling, nutritional and microbiome interventions, and novel vaccine platforms to overcome immunological barriers in LMICs.