Immunization, Vaccines and Biologicals

Rotavirus

Rotaviruses are the most common cause of severe diarrhoeal disease in young children throughout the world. According to WHO 2008 estimates, about 450 000 children aged <5 years die each year from vaccine-preventable rotavirus infections; the vast majority of these children live in low-income countries.

Two oral, live, attenuated rotavirus vaccines, Rotarix™ (derived from a single common strain of human rotavirus) and RotaTeq™ (reassorted bovine-human rotavirus), are available internationally; and both vaccines are considered highly effective in preventing severe gastrointestinal disease. In low income countries, vaccine efficacy can be lower than in industrialized settings, similar to other live oral vaccines, but even with this lower efficacy a greater reduction in absolute numbers of severe gastroenteritis and death was seen, due to the higher background rotavirus disease incidence.

WHO recommends that rotavirus vaccines should be included in all national immunization programmes and considered a priority particularly in countries in South and Southeast Asia and sub-Saharan Africa. WHO continues to recommend that the first dose of either RotaTeq™ or Rotarix™ be administered as soon as possible after 6 weeks of age, along with DTP vaccination. Apart from a low risk of intussusception (about 1-2 per 100 000 infants vaccinated) the current rotavirus vaccines are considered safe and well tolerated.

The public health impact of rotavirus vaccination has been demonstrated in several countries. For example, in the USA, a measurable decrease was seen in the number of rotavirus gastroenteritis hospitalizations accompanied by a suggested herd effect protecting older non-vaccinated children, while in Mexico a decline of up to 50% in diarrhoeal deaths in children < 5 years of age was attributed directly to the use of the vaccine.

WHO reiterates that the use of rotavirus vaccines should be part of a comprehensive strategy to control diarrhoeal diseases with the scaling up of both prevention (promotion of early and exclusive breastfeeding, handwashing with soap, improved water and sanitation) and treatment packages (including low-osmolarity ORS and zinc).

WHO position paper

Disease burden and surveillance

Further information

Resources

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Last updated: 27 January 2014

Highlights

28 November 2014