Official guidelines are crucial for new vaccines to be accepted by physicians and policy makers, and for reimbursement decisions, particularly for vaccines against diseases with an under-appreciated burden, such as rotavirus gastroenteritis (RVGE). Evidence-based guidelines, which take into account the best available data, ensure that new vaccine introductions achieve the greatest sustainable impact. For rotavirus vaccination, guidelines are specific to the locality for which they are developed, reflecting, for example, potential differences in disease burden, prevalence of co-infections (e.g. human immunodeficiency virus) and existing vaccination schedules. By adapting existing evidence-based guidelines, local strategies can be devised to optimise protection against RVGE in different settings. © 2010.