Protective immunity against group A rotavirus infection and illness in infants.

Understanding of the protective effect provided by natural rotavirus infections against subsequent rotavirus infections is required for evaluating vaccine development programs. Prior studies of the protective efficacy of natural infections and correlates of natural protection are reviewed and results from several studies presented only in abstract form are summarized to provide a current assessment of knowledge in this area. Six cohort studies have reported rates for the protective efficacy of a natural rotavirus infection against subsequent infection, diarrhea, or severe diarrhea. These efficacy estimates ranged from 0 to 100% and are not directly comparable because of differences in methodology and population monitored. Results from other study designs also have been confusing, until recently. Recent studies have identified immunologic correlates of protection and studies from a cohort of intensely monitored Mexican children promise to provide a comprehensive assessment of the strength of the protective effect of natural rotavirus infection.