Demographic Variability, Vaccination, and the Spatiotemporal Dynamics of Rotavirus Epidemics

<jats:title>Ecology of Diarrhea</jats:title> <jats:p> Rotavirus is an important cause of morbidity and mortality globally, and, although the infection takes a terrible toll on infant lives, its epidemiology is rather poorly known. New vaccines have become available and are being introduced in the United States prior to global rollout, but they may have some unexpected effects on disease dynamics. <jats:bold> Pitzer <jats:italic>et al.</jats:italic> </jats:bold> (p. <jats:related-article xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="doi" page="290" related-article-type="in-this-issue" vol="325" xlink:href="10.1126/science.1172330">290</jats:related-article> ; see the Perspective by <jats:bold> <jats:related-article xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="doi" issue="5938" page="274" related-article-type="in-this-issue" vol="325" xlink:href="10.1126/science.1177475">Medley and Nokes</jats:related-article> </jats:bold> ) analyzed data and developed models describing the epidemiology of rotavirus before and during adoption of the vaccine. Ecological analysis showed that the birth rate predicted the timing of epidemics much better than climatic variables and that shifts in birth rates explained changes over the years. But as increasing numbers of infants are vaccinated, the pool of susceptible individuals in the population will be reduced, which will affect the annual waves of geographic spread of rotavirus. </jats:p>