Species A rotavirus (RVA) is the leading cause of severe
childhood gastroenteritis worldwide and accounts for about
2 million hospitalizations and 453 000 deaths among young
children annually.1,2
In 2006, the World Health Organization
(WHO) recommended including two RVA vaccines in national
immunization programmes in the Americas and Europe – after
both vaccines had been found to show high efficacy and safety
in clinical trials in these regions.2
By 2009, the same vaccines
had been found to be efficacious in Africa and Asia and WHO
therefore expanded its recommendation to include all children
worldwide.2
Nearly 40 countries – most of them high- or
middle-income – have introduced an RVA vaccine into their
national programmes. Early evaluations after the introduction
of these vaccines in high- or middle-income countries have
shown a drop in hospitalizations for diarrhoea ranging from
33 to 50%.3–9
RVA vaccines have appeared to perform less well
in low-income countries.10–12 The impact of RVA vaccination
in different socioeconomic groups within a single country has
not yet been investigated