Each year it is estimated that group A rotavirus infection causes around 800 000 deaths worldwide from gastroenteritis in children under 5 years of age.1 Symptoms usually accompany primary infection, which is followed by protection against subsequent symptomatic infection.2 For this reason, the peak attack rates for symptomatic rotavirus disease occur in children between 6 and 12 months of age.3

The development of rotavirus vaccines has focused mainly on the use of orally administered live attenuated rotaviruses from non-human hosts. A recent modification was the production of tetravalent vaccines containing “reassortant” strains of rotavirus (TV-RRV).4 These reassortants contain 10 genes from rhesus monkey strains and one gene that codes for human serotypes G1, G2, and G4; the rhesus rotavirus itself provides coverage for serotype G3.4 Efficacy studies in the USA, Finland, and Venezuela have demonstrated that TV-RRV provides good protection against severe rotavirus diarrhoea.5-7 In the USA, TV-RRV is now recommended for routine use by both the Advisory Committee on Immunizations Practices8 and the American Academy of Pediatrics.9 In …