6 December 2023

Researchers in the Northern Territory are determining whether Aboriginal and Torres Strait Islander children aged from 6 to < 12 months old should receive a third booster dose of rotavirus vaccine, in a bid to stop young children from developing severe gastroenteritis that can cause hospitalisation and even death, according to research funded through Royal Australasian College of Physicians Foundation.

Rotavirus is a highly infectious disease that can cause vomiting, diarrhoea and dehydration. It is the leading cause of paediatric diarrhoea deaths worldwide.

Global introduction of oral rotavirus vaccines from 2006 onwards has reduced early childhood deaths because of rotavirus, from approximately 500,000 per year to a little more than 200,000 children per year.

In Australia oral rotavirus vaccines have almost eliminated severe rotavirus disease for most Australian children, however, hospitalisations for Aboriginal and Torres Strait Islander children in rural and remote northern Australia remain > 20 times higher than for non-Indigenous children in southern states and territories.

Lead researcher, paediatrician and RACP Fellowship award recipient Dr Bianca Middleton said clinicians are urgently seeking new ways to better protect Aboriginal and Torres Strait Islander children from diarrhoea illness.

“Right now, the rotavirus vaccine is not fully protecting Aboriginal and Torres Strait Islander children against severe rotavirus disease, and we still see young children being admitted to hospital with rotavirus infection,” said Dr Middleton.

“Children under the age of two years are most susceptible to developing severe cases of rotavirus, which can lead to dehydration and hospitalisation.”

In a bid to protect Aboriginal and Torres Strait Islanders children from developing severe rotavirus, Dr Middleton and her colleagues are running a world-first clinical trial to determine whether Aboriginal and Torres Strait Islander children should receive a third booster dose of rotavirus vaccine in the second six months of life.

“At present all Australian children receive two doses of oral rotavirus vaccine - at 6 weeks and then again at 4 months old – as part of Australia’s National Immunisation Program,” Dr Middleton said.

“Our clinical trial is testing if giving a third booster dose of oral rotavirus vaccine between the ages of 6 to < 12 months will provide better protection against severe rotavirus disease and stop children going to hospital.

“Hospitalisation for children living in remote communities in the Northern Territory is quite the ordeal and often involves aeromedical retrieval services to fly the children and their families to the nearest hospital which can be several hundred kilometres from their home – it places enormous strain on health services, retrieval services, families and remote communities as a whole.

"The trial, which began in 2018, currently has 800 Aboriginal and Torres Strait Islander children enrolled. At its completion, it will include 1,000 children and will follow them until they are three years of age to determine whether an extra booster shot stops them from presenting to healthcare centres and hospitals for treatment of severe dehydration and diarrhoea. 

“Worldwide, rotavirus is still a deadly disease, especially in Africa, Southeast Asia, and unfortunately, in places such as the Northern Territory. However, we are confident that our study will show the extra booster will keep vulnerable children out of hospital wards.

"If, as we predict, the booster will give children advanced protection, we expect the extra dose will be recommended for Aboriginal and Torres Strait Islander children as part of Australia’s National Immunisation Program.

"The rotavirus vaccine has saved the lives of countless children across the globe. However, it seems some children could use some extra help when combating this deadly disease. Which is why are hopeful our research will not just help kids in the Top End, but also children in other global hotspots in Southeast Asia and across Africa.”

For more about the RACP Foundation recipients, visit here