Rotavirus disease kills approximately half a million children annually in developing countries and accounts for one third of hospitalizations for diarrhea worldwide.¹ In 1999, global efforts to control the tremendous health burden of gastroenteritis suffered an abrupt and unanticipated setback. The first licensed rotavirus vaccine (RotaShield) was withdrawn from the U.S. market less than a year after its introduction because it was associated with an uncommon but potentially life-threatening adverse event, intussusception, at an estimated rate of 1 incident per 10,000 vaccine recipients.²

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Debate ensued over the possible use of this vaccine in developing countries, where the health . . .