title: Progress in the introduction of the rotavirus vaccine in Latin America and the Caribbean: four years of accumulated experience.
abstract: BACKGROUND
  Two effective and safe rotavirus vaccines became available in 2006 and have been recommended for use in all countries by the World Health Organization. This article provides an update on the use of rotavirus vaccine in Latin American and Caribbean (LAC) countries.
  
  
  METHODS
  Data reported by LAC countries to the Pan American Health Organization (PAHO) were reviewed.
  
  
  RESULTS
  As of May 2010, 14 LAC countries and 1 territory have introduced the rotavirus vaccine into their national expanded program on immunization (EPI). Reported coverage levels for rotavirus vaccine are lower than those for other EPI vaccines recommended at the same age. A total of 15 LAC countries are part of the PAHO's LAC rotavirus surveillance network; 12 of them are using the vaccine. LAC countries are conducting several studies on rotavirus vaccine effectiveness, cost-effectiveness, and monitoring safety. Also, LAC countries are generating lessons learned on the public health implications of introducing a new vaccine into the EPI. Nine countries and the Cayman Islands pay for the entire cost of the vaccine using government funds. All but 2 countries purchase their rotavirus vaccine through PAHO's Revolving Fund.
  
  
  CONCLUSIONS
  Rotavirus vaccine introduction in LAC has been faster than for other new vaccines, but coverage levels need to increase to maximize the effect of the intervention. Rotavirus surveillance needs to expand and be strengthened to better assess the effect of vaccine use. LAC countries will continue to provide useful data to monitor rotavirus trends and vaccine effect.
authors.affiliation: Comprehensive Family Immunization Project, Pan American Health Organization, Washington, DC, USA. oliveirl@paho.org
authors.forename: Lucia Helena
authors.initials: LH
authors.lastname: de Oliveira
authors.forename: M Carolina
authors.initials: MC
authors.lastname: Danovaro-Holliday
authors.forename: N Jennifer
authors.initials: NJ
authors.lastname: Sanwogou
authors.forename: Cuauhtemoc
authors.initials: C
authors.lastname: Ruiz-Matus
authors.forename: Gina
authors.initials: G
authors.lastname: Tambini
authors.forename: Jon Kim
authors.initials: JK
authors.lastname: Andrus
mesh_terms: D017691:Caribbean Region; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D006801:Humans; D007223:Infant; D007843:Latin America; D022243:Rotavirus Vaccines / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D014611:Vaccination / Q000009:adverse effects / Q000191:economics / Q000706:statistics & numerical data* / Q000639:trends*
chemical_list: D022243:Rotavirus Vaccines