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Rotavirus vaccine has now been introduced into 114 countries but many children throughout the world still remain unimmunised. We know that rotavirus vaccines have a lower protective efficacy in low-income, high child mortality countries compared with its efficacy in high-income, low child mortality countries. Rotavirus vaccines do reduce rotavirus-related deaths and hospitalisations but are less effective in high child mortality countries. There are a number of plausible reasons for this and Witte D et al [Lancet Infect Dis 2022;22: 668–78. https://doi.org/10.1016/S1473-3099(21)00473-4] discuss these reasons in their phase 2, randomised, double-blind, parallel group dose-ranging study of three doses of …
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