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Should India launch a national immunisation programme against rotavirus? No

BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e7832 (Published 30 November 2012) Cite this as: BMJ 2012;345:e7832

Re: Should India launch a national immunisation programme against rotavirus? No

I would simply like to note that Jacob Puliyel, in another response, has claimed that the Cochrane metareview of the Rotavirus vaccines "does not to reduce childhood mortality", and has cited the following:

Soares-Weiser K, Maclehose H, Bergman H, Ben-Aharon I, Nagpal S, Goldberg E, et al. Vaccines for preventing rotavirus diarrhoea: vaccines in use. Cochrane Database Syst Rev 2012;2:CD008521

I would merely like to point out that this use of the review is incorrect. I suspect that he was confused by the following sentence:
"Versus the placebo groups, participants in each vaccine group had similar numbers of deaths, serious adverse events, reactogenicity profiles (fever, diarrhoea, and vomiting), and adverse events that required discontinuation of the vaccination schedule." A closer reading of the text would reveal that the three Rotavirus vaccines have similar numbers of deaths and adverse reactions to EACH OTHER, not to placebo. Also, Puliyel seems to have inconveniently left out the other conclusions: that all three vaccines are "effective at reducing rotavirus diarrhoea (severe cases and cases of any severity). They also reduced all-cause diarrhoea (severe cases), and hospitalizations and need for medical attention caused by rotavirus diarrhoea" [with the exception of Rotarix, where it is simply that more data are needed regarding all-cause diarrheoa], and the review recommended that vaccination should proceed as an effective health intervention in countries of all income levels, though of course there should be ongoing safety monitoring.

If one is to make a case for the best possible care for children, surely one should try to be accurate about the evidence. Isn't that the point?

Competing interests: No competing interests
30 December 2012
J L Batik
systems support technician
University of Aberdeen
Dunbar Street, Aberdeen AB24 3QY
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