rotavirus vaccines

Summary

Summary: Vaccines or candidate vaccines used to prevent infection with ROTAVIRUS.

Top Publications

  1. Castilla J, Beristain X, Martínez Artola V, Navascués A, García Cenoz M, Alvarez N, et al. Effectiveness of rotavirus vaccines in preventing cases and hospitalizations due to rotavirus gastroenteritis in Navarre, Spain. Vaccine. 2012;30:539-43 pubmed publisher
    Two rotavirus vaccines have been available since 2006. This study evaluates the effectiveness of these vaccines using a test-negative case-control design in Navarre, Spain...
  2. Latipov R, Khudoyorov R, Flem E. Childhood intussusception in Uzbekistan: analysis of retrospective surveillance data. BMC Pediatr. 2011;11:22 pubmed publisher
    ..of baseline incidence of childhood intussusception could help safety monitoring after the introduction of rotavirus vaccines. We studied the incidence of intussusception in Uzbekistan, a GAVI-fund eligible state in Central Asia...
  3. do Carmo G, Yen C, Cortes J, Siqueira A, de Oliveira W, Cortez Escalante J, et al. Decline in diarrhea mortality and admissions after routine childhood rotavirus immunization in Brazil: a time-series analysis. PLoS Med. 2011;8:e1001024 pubmed publisher
    ..These real-world data are consistent with evidence obtained from clinical trials and strengthen the evidence base for the introduction of rotavirus vaccination as an effective measure for controlling severe and fatal childhood diarrhea. ..
  4. Iturriza Gomara M, Dallman T, Banyai K, Bottiger B, Buesa J, Diedrich S, et al. Rotavirus genotypes co-circulating in Europe between 2006 and 2009 as determined by EuroRotaNet, a pan-European collaborative strain surveillance network. Epidemiol Infect. 2011;139:895-909 pubmed publisher
  5. Steele A, Patel M, Cunliffe N, Bresee J, Borgstein E, Parashar U. Workshop on intussusception in African countries--meeting report. Vaccine. 2012;30 Suppl 1:A185-9 pubmed publisher
    ..After the recent completion of successful trials of 2 new rotavirus vaccines, the World Health Organization has recommended these vaccines for all children worldwide...
  6. McClenahan S, Krause P, Uhlenhaut C. Molecular and infectivity studies of porcine circovirus in vaccines. Vaccine. 2011;29:4745-53 pubmed publisher
    ..S.-licensed rotavirus vaccines and in cells used to produce inactivated poliovirus vaccines...
  7. Kawamura N, Tokoeda Y, Oshima M, Okahata H, Tsutsumi H, van Doorn L, et al. Efficacy, safety and immunogenicity of RIX4414 in Japanese infants during the first two years of life. Vaccine. 2011;29:6335-41 pubmed publisher
    ..3% (95% CI: 68.9-95%) in RIXX4414 group. RIX4414 was efficacious, well-tolerated and immunogenic in Japanese infants and introduction of vaccination could help in reducing the disease burden. ..
  8. Shui I, Baggs J, Patel M, Parashar U, Rett M, Belongia E, et al. Risk of intussusception following administration of a pentavalent rotavirus vaccine in US infants. JAMA. 2012;307:598-604 pubmed publisher
    Current rotavirus vaccines were not associated with intussusception in large prelicensure trials...
  9. Omeñaca F, Sarlangue J, Szenborn L, Nogueira M, Suryakiran P, Smolenov I, et al. Safety, reactogenicity and immunogenicity of the human rotavirus vaccine in preterm European Infants: a randomized phase IIIb study. Pediatr Infect Dis J. 2012;31:487-93 pubmed publisher
    ..2 U/mL (95% CI: 56.1-216.5) and 234.8 U/mL (95% CI: 173.4-318.0; exploratory analysis). Two doses of RIX4414 were immunogenic and well-tolerated in European preterm infants. ..

More Information

Publications62

  1. Phua K, Lim F, Lau Y, Nelson E, Huang L, Quak S, et al. Rotavirus vaccine RIX4414 efficacy sustained during the third year of life: a randomized clinical trial in an Asian population. Vaccine. 2012;30:4552-7 pubmed publisher
    ..0% [84.8-100]) and pooled non-G1 RV types (94.9% [80.2-99.4]). This study shows that the vaccine is highly efficacious, regardless of circulating RV-types, up to the first 3 years of life in affluent Asian urban populations. ..
  2. Yen C, Tate J, Wenk J, Harris J, Parashar U. Diarrhea-associated hospitalizations among US children over 2 rotavirus seasons after vaccine introduction. Pediatrics. 2011;127:e9-e15 pubmed publisher
    ..Given the variability in diarrhea-related hospitalization trends over the 2 postvaccine seasons according to age group and region, continued surveillance is required for full assessment of the impact of rotavirus vaccination. ..
  3. Kirkwood C. Genetic and antigenic diversity of human rotaviruses: potential impact on vaccination programs. J Infect Dis. 2010;202 Suppl:S43-8 pubmed publisher
    The successful development and implementation of rotavirus vaccines will have a significant impact on rotavirus-induced gastroenteritis in children worldwide...
  4. Lanzieri T, Linhares A, Costa I, Kolhe D, Cunha M, Ortega Barria E, et al. Impact of rotavirus vaccination on childhood deaths from diarrhea in Brazil. Int J Infect Dis. 2011;15:e206-10 pubmed publisher
    ..The decreased rates of childhood gastroenteritis-related deaths in Brazil following rotavirus vaccine introduction, particularly among children <1 year of age, suggest the potential benefit of vaccination. ..
  5. Lopman B, Curns A, Yen C, Parashar U. Infant rotavirus vaccination may provide indirect protection to older children and adults in the United States. J Infect Dis. 2011;204:980-6 pubmed publisher
    ..This study demonstrates a previously unrecognized burden of severe rotavirus in the population >5 years and the primacy of very young children in the transmission of rotavirus. ..
  6. Soares Weiser K, Maclehose H, Bergman H, Ben Aharon I, Nagpal S, Goldberg E, et al. Vaccines for preventing rotavirus diarrhoea: vaccines in use. Cochrane Database Syst Rev. 2012;11:CD008521 pubmed publisher
    ..Currently licensed rotavirus vaccines include a monovalent rotavirus vaccine (RV1; Rotarix, GlaxoSmithKline Biologicals) and a pentavalent ..
  7. Ward R, Clark H, Offit P. Influence of potential protective mechanisms on the development of live rotavirus vaccines. J Infect Dis. 2010;202 Suppl:S72-9 pubmed publisher
    ..Development of live rotavirus vaccines has been highly influenced by views regarding the importance of serotype-specific neutralizing antibody...
  8. Snelling T, Andrews R, Kirkwood C, Culvenor S, Carapetis J. Case-control evaluation of the effectiveness of the G1P[8] human rotavirus vaccine during an outbreak of rotavirus G2P[4] infection in central Australia. Clin Infect Dis. 2011;52:191-9 pubmed publisher
    ..Evidence was not found for an overall protective effect of human rotavirus vaccine against hospitalization for rotavirus disease in this setting. Post hoc analyses suggested a protective effect against severe disease in young infants. ..
  9. Desai S, Esposito D, Shapiro E, Dennehy P, Vazquez M. Effectiveness of rotavirus vaccine in preventing hospitalization due to rotavirus gastroenteritis in young children in Connecticut, USA. Vaccine. 2010;28:7501-6 pubmed publisher
    ..3% (95% C.I.: 55.4%-99.3%; p=0.006) for hospitalized controls and 96.9% (95% C.I.: 59.4%-99.8%; p=0.008) for community controls. ..
  10. Payne D, Staat M, Edwards K, Szilagyi P, Weinberg G, Hall C, et al. Direct and indirect effects of rotavirus vaccination upon childhood hospitalizations in 3 US Counties, 2006-2009. Clin Infect Dis. 2011;53:245-53 pubmed publisher
    ..Routine rotavirus vaccination of US infants began in 2006. We conducted active, population-based surveillance for rotavirus gastroenteritis hospitalizations in 3 US counties to assess vaccine impact...
  11. Matson D, Staat M, Azimi P, Itzler R, Bernstein D, Ward R, et al. Burden of rotavirus hospitalisations in young children in three paediatric hospitals in the United States determined by active surveillance compared to standard indirect methods. J Paediatr Child Health. 2012;48:698-704 pubmed publisher
    ..This 2-year study conducted at three hospitals prior to the licensure of the rotavirus vaccines in the USA compared two indirect methods for estimating hospitalisations for rotavirus gastroenteritis with ..
  12. Moon S, Tate J, Ray P, Dennehy P, Archary D, Coutsoudis A, et al. Differential profiles and inhibitory effect on rotavirus vaccines of nonantibody components in breast milk from mothers in developing and developed countries. Pediatr Infect Dis J. 2013;32:863-70 pubmed publisher
    Live oral rotavirus vaccines have been less immunogenic and efficacious for children of developing countries than for those in middle income and industrialized countries, and the basis for these differences is not fully understood...
  13. Kirkwood C, Boniface K, Barnes G, Bishop R. Distribution of rotavirus genotypes after introduction of rotavirus vaccines, Rotarix® and RotaTeq®, into the National Immunization Program of Australia. Pediatr Infect Dis J. 2011;30:S48-53 pubmed publisher
    b>Rotavirus vaccines, RotaTeq and Rotarix, were introduced into the Australian National Immunization Program on July 1, 2007...
  14. Yen C, Tate J, Steiner C, Cortese M, Patel M, Parashar U. Trends in intussusception hospitalizations among US infants before and after implementation of the rotavirus vaccination program, 2000-2009. J Infect Dis. 2012;206:41-8 pubmed publisher
    Although US data have not documented an intussusception risk with current rotavirus vaccines, international data indicate a possible low risk, primarily after the first dose...
  15. Zeller M, Rahman M, Heylen E, De Coster S, De Vos S, Arijs I, et al. Rotavirus incidence and genotype distribution before and after national rotavirus vaccine introduction in Belgium. Vaccine. 2010;28:7507-13 pubmed publisher
    ..b>Rotavirus vaccines have strongly reduced the number of children hospitalized due to a rotavirus infection at the GUH; it is ..
  16. Tate J, Steele A, Bines J, Zuber P, Parashar U. Research priorities regarding rotavirus vaccine and intussusception: a meeting summary. Vaccine. 2012;30 Suppl 1:A179-84 pubmed publisher
    Currently available rotavirus vaccines have been associated with a small increased risk of intussusception (~1-2 cases per 100,000 vaccinated infants) in some populations...
  17. Plosker G. Rotavirus vaccine RIX4414 (Rotarix™): a pharmacoeconomic review of its use in the prevention of rotavirus gastroenteritis in developed countries. Pharmacoeconomics. 2011;29:439-54 pubmed publisher
    ..Actual tender prices of a full vaccination course for each vaccine were not known at the time of the analyses and therefore had to be estimated...
  18. Fang A, Tingay D. Early observations in the use of oral rotavirus vaccination in infants with functional short gut syndrome. J Paediatr Child Health. 2012;48:512-6 pubmed publisher
    ..Overall, rotavirus vaccination did not alter weight gain, temperature or urinary sodium. In this small series, oral live-attenuated rotavirus vaccination of infants with high-output ileostomy was tolerated in most cases. ..
  19. Rozenbaum M, Mangen M, Giaquinto C, Wilschut J, Hak E, Postma M. Cost-effectiveness of rotavirus vaccination in the Netherlands; the results of a consensus model. BMC Public Health. 2011;11:462 pubmed publisher
  20. Dey A, Wang H, Menzies R, Macartney K. Changes in hospitalisations for acute gastroenteritis in Australia after the national rotavirus vaccination program. Med J Aust. 2012;197:453-7 pubmed
    ..To evaluate the impact of the Australian rotavirus vaccination program on both rotavirus and all-cause acute gastroenteritis (AGE) hospitalisations and to compare outcomes in Indigenous and non-Indigenous people...
  21. Tate J, Burton A, Boschi Pinto C, Steele A, Duque J, Parashar U. 2008 estimate of worldwide rotavirus-associated mortality in children younger than 5 years before the introduction of universal rotavirus vaccination programmes: a systematic review and meta-analysis. Lancet Infect Dis. 2012;12:136-41 pubmed publisher
    WHO recommends routine use of rotavirus vaccines in all countries, particularly in those with high mortality attributable to diarrhoeal diseases...
  22. Fu C, He Q, Xu J, Xie H, Ding P, Hu W, et al. Effectiveness of the Lanzhou lamb rotavirus vaccine against gastroenteritis among children. Vaccine. 2012;31:154-8 pubmed publisher
    ..Therefore, earlier immunization and the administration of the full immunization regimen should be encouraged...
  23. Field E, Vally H, Grimwood K, Lambert S. Pentavalent rotavirus vaccine and prevention of gastroenteritis hospitalizations in Australia. Pediatrics. 2010;126:e506-12 pubmed publisher
    ..Additional direct and indirect effects are substantial and include reductions in nonrotavirus AGE hospitalizations in vaccinated age groups and rotavirus and nonrotavirus AGE hospitalization rates in older age groups. ..
  24. Tu H, Woerdenbag H, Kane S, Rozenbaum M, Li S, Postma M. Economic evaluations of rotavirus immunization for developing countries: a review of the literature. Expert Rev Vaccines. 2011;10:1037-51 pubmed publisher
    ..Since 2006, two rotavirus vaccines, Rotarix and Rotateq, have been available in the market...
  25. Tregnaghi M, Abate H, Valencia A, Lopez P, da Silveira T, Rivera L, et al. Human rotavirus vaccine is highly efficacious when coadministered with routine expanded program of immunization vaccines including oral poliovirus vaccine in Latin America. Pediatr Infect Dis J. 2011;30:e103-8 pubmed publisher
    ..RIX4414 was highly efficacious against severe rotavirus gastroenteritis caused by the circulating wild-type rotavirus (G1 and non-G1) when coadministered with routine EPI vaccines including OPV. ..
  26. Zickafoose J, Benneyworth B, Riebschleger M, Espinosa C, Davis M. Hospitalizations for intussusception before and after the reintroduction of rotavirus vaccine in the United States. Arch Pediatr Adolesc Med. 2012;166:350-5 pubmed publisher
    ..3 (95% CI, 29.0-37.6) per 100,000 infants. The reintroduction of rotavirus vaccine since 2006 has not resulted in a detectable increase in the number of hospital discharges for intussusception among US infants. ..
  27. Banyai K, László B, Duque J, Steele A, Nelson E, Gentsch J, et al. Systematic review of regional and temporal trends in global rotavirus strain diversity in the pre rotavirus vaccine era: insights for understanding the impact of rotavirus vaccination programs. Vaccine. 2012;30 Suppl 1:A122-30 pubmed publisher
    Recently, two rotavirus vaccines have been recommended for routine immunization of infants worldwide...
  28. Velazquez F, Colindres R, Grajales C, Hernández M, Mercadillo M, Torres F, et al. Postmarketing surveillance of intussusception following mass introduction of the attenuated human rotavirus vaccine in Mexico. Pediatr Infect Dis J. 2012;31:736-44 pubmed publisher
    ..It is still uncertain whether rotavirus vaccination has any impact on the overall incidence of intussusception. This finding has to be put in perspective with the well-documented substantial benefits of rotavirus vaccination. ..
  29. Hutubessy R, Henao A, Namgyal P, Moorthy V, Hombach J. Results from evaluations of models and cost-effectiveness tools to support introduction decisions for new vaccines need critical appraisal. BMC Med. 2011;9:55 pubmed publisher
  30. Patel M, Glass R, Desai R, Tate J, Parashar U. Fulfilling the promise of rotavirus vaccines: how far have we come since licensure?. Lancet Infect Dis. 2012;12:561-70 pubmed publisher
    Rotavirus is the most common cause of fatal and severe childhood diarrhoea worldwide. Two new rotavirus vaccines have shown efficacy against severe rotavirus disease in large clinical trials...
  31. Desai R, Curns A, Steiner C, Tate J, Patel M, Parashar U. All-cause gastroenteritis and rotavirus-coded hospitalizations among US children, 2000-2009. Clin Infect Dis. 2012;55:e28-34 pubmed publisher
    ..Rotavirus vaccine was recommended for US infants in 2006. We estimated baseline prevaccine burden and monitored postvaccine trends in gastroenteritis-coded and rotavirus-coded hospitalizations among US children...
  32. Todd S, Page N, Duncan Steele A, Peenze I, Cunliffe N. Rotavirus strain types circulating in Africa: Review of studies published during 1997-2006. J Infect Dis. 2010;202 Suppl:S34-42 pubmed publisher
    ..These data imply that rotavirus vaccines will need to confer protection against a wide variety of strain types in Africa and emphasize the importance ..
  33. Berry S, Johns B, Shih C, Berry A, Walker D. The cost-effectiveness of rotavirus vaccination in Malawi. J Infect Dis. 2010;202 Suppl:S108-15 pubmed publisher
    ..Adopting Rotarix would likely be highly cost-effective for Malawi, particularly with GAVI support. This finding holds true across uncertainty ranges for key variables, including efficacy, for which data are becoming available. ..
  34. De Blasio B, Kasymbekova K, Flem E. Dynamic model of rotavirus transmission and the impact of rotavirus vaccination in Kyrgyzstan. Vaccine. 2010;28:7923-32 pubmed publisher
    New rotavirus vaccines show promise to reduce the burden of severe diarrhea among children in developing countries...
  35. Patel M, López Collada V, Bulhões M, de Oliveira L, Bautista Márquez A, Flannery B, et al. Intussusception risk and health benefits of rotavirus vaccination in Mexico and Brazil. N Engl J Med. 2011;364:2283-92 pubmed publisher
    ..Funded in part by the GAVI Alliance and the U.S. Department of Health and Human Services.). ..
  36. Buttery J, Danchin M, Lee K, Carlin J, McIntyre P, Elliott E, et al. Intussusception following rotavirus vaccine administration: post-marketing surveillance in the National Immunization Program in Australia. Vaccine. 2011;29:3061-6 pubmed publisher
    ..Larger population-based studies using linked databases are required to provide more definitive evidence. ..
  37. Molto Y, Cortes J, de Oliveira L, Mike A, Solis I, Suman O, et al. Reduction of diarrhea-associated hospitalizations among children aged < 5 Years in Panama following the introduction of rotavirus vaccine. Pediatr Infect Dis J. 2011;30:S16-20 pubmed publisher
    ..RV1 appears to have had a substantial impact on diarrhea-associated hospitalizations among young children in Panama. ..
  38. Anderson E, Rupp A, Shulman S, Wang D, Zheng X, Noskin G. Impact of rotavirus vaccination on hospital-acquired rotavirus gastroenteritis in children. Pediatrics. 2011;127:e264-70 pubmed publisher
    ..Vaccination efforts should be encouraged as a strategy to affect the substantial burden of HA rotavirus. ..
  39. Glass R, Parashar U, Patel M, Gentsch J, Jiang B. Rotavirus vaccines: successes and challenges. J Infect. 2014;68 Suppl 1:S9-18 pubmed publisher
    Since 2006, the availability of two new rotavirus vaccines has raised enthusiasm to consider the eventual control and elimination of severe rotavirus diarrhea through the global use of vaccines...
  40. Armah G, Sow S, Breiman R, Dallas M, Tapia M, Feikin D, et al. Efficacy of pentavalent rotavirus vaccine against severe rotavirus gastroenteritis in infants in developing countries in sub-Saharan Africa: a randomised, double-blind, placebo-controlled trial. Lancet. 2010;376:606-14 pubmed publisher
    Rotavirus gastroenteritis causes many deaths in infants in sub-Saharan Africa. Because rotavirus vaccines have proven effective in developed countries but had not been tested in developing countries, we assessed efficacy of a pentavalent ..
  41. Koch J, Wiese Posselt M. Epidemiology of rotavirus infections in children less than 5 years of age: Germany, 2001-2008. Pediatr Infect Dis J. 2011;30:112-7 pubmed publisher
    ..An RV-surveillance system is in place in Germany that could potentially monitor the effect of an RV-vaccination program once implemented. ..
  42. Justino M, Linhares A, Lanzieri T, Miranda Y, Mascarenhas J, Abreu E, et al. Effectiveness of the monovalent G1P[8] human rotavirus vaccine against hospitalization for severe G2P[4] rotavirus gastroenteritis in Belém, Brazil. Pediatr Infect Dis J. 2011;30:396-401 pubmed publisher
    ..VE was highest in children aged 3 to 11 months. However, protection in children ? 12 months of age, important for optimal public health impact, was significantly sustained based on estimates obtained using neighborhood controls. ..
  43. Cortese M, Leblanc J, White K, Jerris R, Stinchfield P, Preston K, et al. Leveraging state immunization information systems to measure the effectiveness of rotavirus vaccine. Pediatrics. 2011;128:e1474-81 pubmed publisher
    ..Two RV5 doses also seem to provide good protection. IISs can be valuable tools for assessing the effectiveness of vaccines administered to young children. ..
  44. Paulke Korinek M, Kundi M, Rendi Wagner P, de Martin A, Eder G, Schmidle Loss B, et al. Herd immunity after two years of the universal mass vaccination program against rotavirus gastroenteritis in Austria. Vaccine. 2011;29:2791-6 pubmed publisher
    ..In 2009 the disease burden was highest in children below three months of age stressing the importance of the early start of the immunization course. ..
  45. Cortes J, Curns A, Tate J, Cortese M, Patel M, Zhou F, et al. Rotavirus vaccine and health care utilization for diarrhea in U.S. children. N Engl J Med. 2011;365:1108-17 pubmed publisher
    ..Routine vaccination of U.S. infants with pentavalent rotavirus vaccine (RV5) began in 2006...
  46. Rivera L, Peña L, Stainier I, Gillard P, Cheuvart B, Smolenov I, et al. Horizontal transmission of a human rotavirus vaccine strain--a randomized, placebo-controlled study in twins. Vaccine. 2011;29:9508-13 pubmed publisher
    ..Whether transmission leads to indirect protection among unvaccinated individuals remains unknown at this stage. ..
  47. Cherian T, Wang S, Mantel C. Rotavirus vaccines in developing countries: the potential impact, implementation challenges, and remaining questions. Vaccine. 2012;30 Suppl 1:A3-6 pubmed publisher
    ..Finally, disease surveillance and studies are required to document the impact of vaccination and monitor changes in disease epidemiology. ..
  48. Quintanar Solares M, Yen C, Richardson V, Esparza Aguilar M, Parashar U, Patel M. Impact of rotavirus vaccination on diarrhea-related hospitalizations among children < 5 years of age in Mexico. Pediatr Infect Dis J. 2011;30:S11-5 pubmed publisher
    ..Rotavirus-specific surveillance and epidemiologic studies are necessary for a better understanding of the changes in disease epidemiology and public health impact from rotavirus vaccination. ..
  49. Liu N, Yen C, Fang Z, Tate J, Jiang B, Parashar U, et al. Projected health impact and cost-effectiveness of rotavirus vaccination among children <5 years of age in China. Vaccine. 2012;30:6940-5 pubmed publisher
    Two rotavirus vaccines have been licensed globally since 2006. In China, only a lamb rotavirus vaccine is licensed and several new rotavirus vaccines are in development...
  50. Martinon Torres F, Martinón Torres N, Bouzón Alejandro M, Redondo Collazo L, Pertega Diaz S, Seoane Pillado M, et al. Acute gastroenteritis hospitalizations among children aged < 5 years before and after introduction of rotavirus vaccines: a hospital-based surveillance study in Galicia, Spain. Hum Vaccin Immunother. 2012;8:946-52 pubmed publisher
    b>Rotavirus vaccines were licensed in Spain between late 2006 and early 2007. Rotavirus vaccination was recommended but not reimbursed by the Spanish National Health System...
  51. Lee B, Assi T, Rajgopal J, Norman B, Chen S, Brown S, et al. Impact of introducing the pneumococcal and rotavirus vaccines into the routine immunization program in Niger. Am J Public Health. 2012;102:269-76 pubmed publisher
    ..Our results suggest that the effects on the vaccine supply chain should be considered when introducing a new vaccine and that computational models can help assess evolving needs and prevent problems with vaccine delivery. ..
  52. Buttery J, Lambert S, Grimwood K, Nissen M, Field E, Macartney K, et al. Reduction in rotavirus-associated acute gastroenteritis following introduction of rotavirus vaccine into Australia's National Childhood vaccine schedule. Pediatr Infect Dis J. 2011;30:S25-9 pubmed publisher
    b>Rotavirus vaccines were introduced into the funded Australian National Immunization Program (NIP) in July 2007...
  53. Staat M, Payne D, Donauer S, Weinberg G, Edwards K, Szilagyi P, et al. Effectiveness of pentavalent rotavirus vaccine against severe disease. Pediatrics. 2011;128:e267-75 pubmed publisher
    ..RV5 was highly effective in preventing severe rotavirus disease, even after a partial series, with protection persisting throughout the second year of life. ..