The World Health Organization recommended on Friday that oral rotavirus vaccines be included in all national immunization programs to avert half a million diarrhoeal deaths and two million hospitalizations a year. Children in Europe and the Americas have had access to the rotavirus vaccine for three years but it had previously not been tested in and approved for low-income settings where the dehydrating disease is most lethal. More than 85 percent of all diarrhea deaths occur in Africa and Asia, where patchy medical coverage means children with severe cases often don't receive rehydration treatment in time to survive. The Seattle-based Program for Appropriate Technology in Health estimates that vaccination can prevent 225,000 child deaths in the developing world each year. Poor countries will be able to apply for funding from the Global Alliance for Vaccines and Immunization to help them buy the vaccine, said spokeswoman Ariane Leroy. The group, which includes governments and private entities such as the Bill and Melinda Gates Foundation, has already pledged to make $4 billion available to developing countries until the end of 2015 - most of it for vaccine programs. “It's very good that the rotavirus vaccine is now recommended for all regions. It's a vaccine that has potential to save many lives,” said Tido von Schoen-Angerer of Medecins Sans Frontieres. The group also known as Doctors Without Borders campaigns for universal access to essential medicines. Dr. Paul Offit, chief of infectious diseases at the Children's Hospital of Philadelphia and the co-inventor of one rotavirus vaccine manufactured by Merck and amp; Co., said immunizing half the children in the United States has reduced the incidence of disease by 80 to 90 percent. Merck's RotaTeq and rival GlaxoSmithKline PLC's Rotarix are administered orally in the first six months after birth. Von Schoen-Angerer said one of the challenges would now be getting the drug to children in that period. “In areas where the regular vaccine program doesn't function well, that might be difficult.” WHO already recommends universal vaccination against tuberculosis; diphtheria; tetanus; whooping cough; haemophilus influenzae type B, or Hib, which can cause meningitis and pneumonia; hepatitis B; human papillomavirus; the pneumococcus bacterium; polio; and measles. “This WHO recommendation clears the way for vaccines that will protect children in the developing world from one of the most deadly diseases they face,” said Tachi Yamada of the Bill & Melinda Gates Foundation. The first vaccine developed to fight rotavirus, sold by Wyeth, was pulled from the market in 1999 after it was linked to a rare, life-threatening type of bowel obstruction known as intussusception. The Merck and Glaxo vaccines do not have that problem. The WHO said clinical trials in poor communities in South Africa and Malawi showed the new oral vaccines significantly reduced severe diarrhea episodes related to rotavirus. Trials are continuing in Bangladesh, Vietnam, Ghana, Mali and Kenya, but the guidance was issued ahead of those full results “since available evidence indicates that efficacy data can be extrapolated to populations with similar mortality patterns regardless of geographic location,” the WHO said. It also stressed that “there are many causes of diarrhoeal disease,” meaning that efforts to improve water quality, sanitation standards and access to rehydration salts must continue despite the expansion of the vaccine.
