[Rotavirus vaccines]

Group A rotavirus is the most common cause of severe gastroenteritis in young children globally, estimated to cause approximately 500,000 deaths each year, mainly in low-income countries. Two oral vaccines are currently licensed, a monovalent attenuated human rotavirus strain (Rotarix®, GSK Biologicals) and a pentavalent human-bovine reassortant vaccine (Rotateq®, Sanofi Pasteur MSD). On the basis of efficacy data from Europe and America, these vaccines were first recommended for routine immunization by WHO in 2006 in these countries. Studies reporting on the impact of rotavirus vaccination in early-introducer countries are now available, they suggest that these vaccines may have a major effect on burden of severe diarrhoea. In 2009, the WHO recommendation was expanded to all infants worldwide. The remaining questions are the vaccine efficacy in Africa and Asia, recent data from clinical trials showing a lower efficacy in these settings, the possible evolution of strains under the pression of selection of vaccination, and the real risk of intussusception after vaccination. In France, rotavirus vaccination has not yet been introduced into the routine immunization program in infants less than 6 months.