這個帖子，又是一個唯恐天下不亂的推送貼！
就用WHO（World Health Organization）立場文件來說話了。這是WHO對疫苗的態(tài)度，
別以訛傳訛。關(guān)于輪狀病毒疫苗你該了解的，這篇應該看看。推送也得負責。
所以，孰是孰非，不用多說。
WHO立場文件中，主要涉及美國的Rotarix™和RotaTeq™ （羅特律和輪達停）。目前國產(chǎn)的為羅特威，蘭州生物所研制，是比較牛的。上述大同小異，安全可靠。
關(guān)于羅特威的論文節(jié)選:
每年應服用1次，是最小閾值。
媒體，也得普及科學、消除誤解，不是用來湊熱鬧的，
別整天圍著“小3”、圍著“人咬狗”，唯恐天下不亂的，
亂推送難免導致偏頗！
WHO立場文件附后：
Rotavirus vaccines WHO position paper
Summary
Rotaviruses (RVs) are globally the leading cause of severe, dehydrating diarrhoea in young children.
Most children have been infected by these highly contagious viruses by the age of 5 years. The
majority of severe rotavirus gastroenteritis (RVGE) episodes occurs in low-income countries and
affects infants under one year of age. WHO estimates that in 2008 there were approximately 453 000
RVGE-associated child deaths. In most low income countries in Asia and Africa, the rotavirus
epidemiology is characterized by episodes of relatively intense viral circulation against a background
of year-round transmission. However, in high income countries in temperate climates, a distinct winter
seasonality is typically observed.
Rotaviruses belong to the Reoviridae family. The outermost layer of these viruses contains the
proteins VP7 and VP4 which stimulate the production of neutralizing antibodies. In human
rotaviruses, at least 12 different VP7 antigens (G-types) and 15 different VP4 antigens (P-types) have
been identified. Currently, 5 G-P combinations (G1P[8], G2P[4], G3P[8], G4P[8]) and G9P[8])
account for approximately 90% of all human rotavirus infections.
Rotaviruses damage the enterocyte lining of the small intestinal villi, leading to reduced absorptive
capacity and diarrhoea. The wide clinical spectrum of rotavirus disease ranges from transient loose
stools to severe diarrhoea and vomiting causing dehydration, electrolyte disturbances, shock and, in
untreated cases, death. The cornerstones of treatment of severe RVGE are fluid replacement and zinc
supplementation. An etiological diagnosis of rotavirus gastroenteritis requires laboratory confirmation.
Currently available vaccines are based on live, oral, attenuated rotavirus strains of human and/or
animal origin that replicate in the human gut. Two rotavirus vaccines are marketed internationally: the
monovalent (RV1) and the pentavalent (RV5). RV1 originates from a human strain, whereas RV5
contains 5 reassortants developed from rotaviruses of human and bovine origin.
A large number of randomized, controlled trials have shown that both RV1 and RV5 are 80%-90%
efficacious against severe RVGE in countries with very low or low child and adult mortality, and 40%
- 60% efficacious in countries with high child mortality and high or very high adult mortality. In most
cases, vaccination in infancy provides protection against severe RVGE for at least 2 years.
Breastfeeding and prematurity (<37 weeks’ gestation) do not significantly impair the response to the
rotavirus vaccines.
In large controlled trials, no differences were observed between the vaccine groups and the placebo
groups in terms of serious adverse events. However, in some, but not all settings, post-marketing
surveillance has detected a small increased risk of intussusception (about 1–2/100 000 infants
vaccinated) shortly after the first dose. Still, the benefits that rotavirus vaccination provides, through
prevention of severe diarrhoea and death from rotavirus infection, far exceed the risk of
intussusception.WHO recommendations: Rotavirus vaccines should be included in all national immunization
programmes and considered a priority, particularly in countries with high RVGE-associated fatality
rates, such as in south and south-eastern Asia and sub-Saharan Africa. The use of rotavirus vaccines
should be part of a comprehensive strategy to control diarrhoeal diseases.
Plans for introduction of rotavirus vaccines should consider the epidemiology of the disease by age,
the coverage and actual age at vaccination and also include an evaluation of the estimated public
health impact and potential risks. It is important to establish the baseline incidence of intussusception.
Proper planning and training of staff to conduct pharmacovigilance should take place before the
vaccine is introduced. Also, caregivers should be adequately counselled to recognize danger signs of
dehydration or intussusception.
The first dose of rotavirus vaccine should be administered as soon as possible after 6 weeks of age. （附注：其實三種疫苗為安全起見，首次均在2月齡開始接種。但6月齡后輪狀病毒導致腹瀉高發(fā)，疫苗一般在6月齡開始接種。）
RV1 should be administered in a 2-dose schedule at the time of DPT1 and DPT2, and RV5 in a 3-dose
schedule at the time of the DTP1, DTP2, and DTP3 contacts. Both vaccines are given orally with an
interval of at least 4 weeks between doses.（附注：口服最小間隔4周）
Infants should receive rotavirus vaccine together with DTP regardless of the time of vaccination.
Rotavirus vaccination of healthy children aged over2 years is not considered necessary. Rotavirus
vaccinations can be administered simultaneously with other routine infant vaccines.
Apart from a very low risk of intussusception, the current rotavirus vaccines are safe and well
tolerated. Major contraindications for rotavirus vaccination are severe allergic reaction after a
previous dose and severe immunodeficiency. Precautions for use of rotavirus vaccination include
a history of intussusception or intestinal malformations, chronic gastrointestinal disease, and
severe acute illness. Vaccination should be postponed when the child has ongoing acute
gastroenteritis or fever with moderate to severe illness.
