Julie Bines
Julie Bines is the inaugural Victor and Loti Smorgon Chair of Paediatrics at the University of Melbourne. She is a paediatric gastroenterologist and head of clinical nutrition at the Royal Children’s Hospital in Melbourne, Australia. Dr. Bines also heads the Rotavirus Vaccine Program for RV3, a new rotavirus vaccine candidate, at the Murdoch Children’s Research Institute. The program is working to develop a low-cost neonatal rotavirus vaccine which would prevent the virus from birth.
Throughout her career, Dr. Bines has focused on rotavirus vaccine safety. She was involved in the development and validation of the Brighton Collaboration clinical case definition of intussusception, WHO documents outlining the epidemiology of intussusception in developing countries, and generic protocols for intussusception and post-marketing surveillance following rotavirus vaccine introduction.
In 2004, Dr. Bines was awarded the Australian National Health and Medical Research Council Practitioner Fellowship and in 1990, she was awarded the Royal Australasian College of Physicians Fellowship.
She received a MBBS from Monash University in Melbourne, Australia in 1982. She received her MD from the University of Melbourne 2000.
The Discovery of Rotavirus
Australia has played a critical role in combatting rotavirus illnesses and deaths worldwide for more than 40 years. In 1973, Australian virologist, Dr. Ruth Bishop, and her team of researchers at the Royal Children’s Hospital in Melbourne first identified the virus. Following on Dr. Bishop’s groundbreaking discovery of the virus, similar studies reported the presence of the virus in diarrheal patients around the world. Two decades after her discovery, Dr. Bishop recalled “it was like pressing a whole lot of light bulbs on a world map… Everyone was saying ‘we have found the virus too.’”
Dr. Julie Bines, a ROTA advisor and a clinician and researcher at the University of Melbourne, was taught and mentored by Dr. Bishop and worked with her for many years. Speaking with Dr. Bines for our Champions Series, she spoke of her rotavirus vaccine advocacy — engaging with opinion leaders and media and presenting to clinicians the severity of rotavirus and benefits of the vaccine. Australia introduced rotavirus vaccines in 2007, an introduction Dr. Bines referred to as being “relatively straightforward with early acceptance from clinicians and public.” Dr. Bines reflected that “part of what made introducing rotavirus vaccines in Australia an easy consideration [was the] demonstrated burden of rotavirus hospitalizations and cost-effective analysis.”
Rotavirus Vaccine Cost Savings
Analyses from 2007-2012 have shown that rotavirus vaccines achieved cost savings for Australia to the tune of A$66 million over the six-year period, a positive outcome that cost-effectiveness analysis did not predict. The unexpected cost savings were due in part to the indirect effects of vaccination—a reduction in rotavirus in older children, often diagnosed as unspecified gastroenteritis.
Continuing Challenges
Rotavirus vaccine coverage in Australia has reached 87% as of 2019, an achievement Dr. Bines largely attributes to “community acceptance of the value of vaccines [and a] strong public health system with funding to support the national immunization program.” Despite the convincing evidence for Australia to implement rotavirus vaccines, challenges persist. Dr. Bines notes the importance of transparency in gaining the public’s trust and support, highlighting how the benefits of rotavirus vaccination greatly outweigh the very small risk of intussusception: “putting in context the justification of continued vaccination … recognizing and prompt treatment of intussusception if this occurs.”
In addition, vaccine hesitancy is a growing issue threatening immunization programs, including rotavirus vaccines. Dr. Bines commented on the challenge to sustain high vaccine coverage noting, “media attention on anti-vaccination lobbies and high profile celebrities making confusing statements have not been helpful in efforts to prevent potentially life-threatening diseases through vaccination.”
The COVID-19 pandemic has compounded immunization challenges across the globe as routine immunization programs are being disrupted, people are hesitant to risk going out into clinics, and overall attention is concentrated on the pandemic. Dr. Bines recognizes the “challenge advocating during the pandemic, stressing the importance to continue routine vaccination programs.” To avoid undoing years of progress in routine immunization and child health, Dr. Bines suggests we “continue to stress the importance of routine immunization [and] provide reassurance of the balance of risks with attending the immunization clinic.” The current COVID-19 crisis further underscores the importance of the work done by pioneers like Dr. Ruth Bishop and scientists and champions such as Dr. Julie Bines.
In recent years, Dr. Bines has been leading a team at the Murdoch Children’s Research Institute in developing a new rotavirus vaccine that utilizes a birth dose strategy to target early prevention of rotavirus and potentially overcome other remaining barriers to vaccine implementation. The legacy of Dr. Bishop remains palpable as this new low-cost, neonatal rotavirus vaccine, called “RV3-BB”, is based on the strain originally identified by Dr. Bishop.