Rotavirus vaccines in developed countries.
OBJECTIVE
Rotavirus is the most common cause of diarrhoea and dehydration in early childhood. The recent licensure in many nations of vaccines against rotavirus offers promise to significantly reduce this toll. The present review describes recent developments regarding rotavirus vaccines and the challenges they face.


RESULTS
Rotavirus causes significant morbidity and impact upon healthcare systems, at both inpatient and outpatient levels. An earlier rotavirus vaccine, since withdrawn, was temporally associated with intussusception causing small bowel obstruction, especially in infants receiving their first dose at an older age. Large-scale safety and efficacy studies of two new live, oral, attenuated vaccines have shown excellent efficacy against severe rotavirus gastroenteritis. Importantly, both studies detected no association with intussusception with these new vaccines when administered at the scheduled ages. Developed using different rotavirus vaccinology philosophies, questions remain regarding their coverage against new rotavirus serotypes. Ongoing intussusception surveillance following introduction should answer whether they may be safely administered beyond scheduled ages.


CONCLUSIONS
Safe, efficacious rotavirus vaccines are available in many developed countries, offering significant promise to reduce the burden of gastroenteritis and dehydration. The impact of these vaccines upon not only morbidity, but also circulating rotavirus serotypes, will be monitored with interest.
Buttery
Jim P
JP
NHMRC Centre of Clinical Research Excellence in Child and Adolescent Immunisation, Murdoch Children's Research Institute, Infectious Diseases Unit, Royal Children's Hospital, Parkville, Australia. jim.buttery@mcri.edu.au
Kirkwood
Carl
C
D002675:Child, Preschool; D019049:Developed Countries; D003906:Developing Countries; D015195:Drug Design; D006801:Humans; D007223:Infant; D007443:Intussusception / Q000209:etiology / Q000517:prevention & control; D032541:Mass Vaccination / Q000009:adverse effects* / Q000379:methods; D012401:Rotavirus / Q000145:classification / Q000276:immunology*; D012400:Rotavirus Infections / Q000150:complications / Q000276:immunology* / Q000517:prevention & control; D022243:Rotavirus Vaccines / Q000009:adverse effects / Q000627:therapeutic use
D022243:Rotavirus Vaccines