The Indian Journal of Pediatrics

, Volume 78, Issue 10, pp 1251–1255 | Cite as

Scope for Rotavirus Vaccination in India: Revisiting the Scientific Evidence

  • Sutapa Bandyopadhyay NeogiEmail author
  • Habib Hasan
  • Kabir Sheikh
  • Sanjay Zodpey
Special Article


Rotavirus vaccines have been developed to prevent deaths resulting from severe diarrhea of rotavirus origin. The use of vaccines as an intervention at scale to prevent and control the burden of rotavirus diarrhea is supported by the argument that prevailing public health measures such as hygiene and sanitation, breast feeding and use of ORS have failed to prevent severe dehydration resulting from diarrhea. The article reviews the existing evidence on the rationale of using rotavirus vaccine as against the feasibility of scaling it up in developing countries like India. The vaccines currently available may not cover the strains circulating in Indian population. The diversity of Rotavirus infection in the country is tremendous and since the safety, immunogenicity and efficacy data has not been collected for India, there is first a need to conduct studies to measure the extent of protection and cross-protection provided by the available vaccines for local strains, before venturing into Rotavirus vaccination program. The potential benefits of immunization have to be first vetted against the risks involved by the policymakers and other stakeholders.


Rotavirus Vaccine India Policy decision 



S N and H H; Did relevant literature search and drafted the manuscript, K S; Gave his inputs on the policy aspects mentioned in the paper, S Z; Provided overall guidance and approved the final version of the manuscript.

Conflict of Interest


Role of Funding Source



  1. 1.
    Keusch GT, Fontaine O, Bhargava A, et al. Diarrheal diseases. In: Jamison DT, Breman JG, Measham A, et al., editors. Disease control priorities in developing countries. 2nd ed. New York: Oxford University Press; 2006. p. 371–87.Google Scholar
  2. 2.
    Parashar UD, Hummelman EG, Bresee JS, Miller MA, Glass RI. Global Illness and Deaths Caused by Rotavirus Disease in Children. Emerg Infect Dis. 2003;9:565–72.PubMedCrossRefGoogle Scholar
  3. 3.
    Kang G, Kelkar SD, Chitambar SD, Ray P, Naik T. Epidemiological profile of rotaviral infection in India: challenges for the 21st century. J Infect Dis. 2005;192:S120–6.PubMedCrossRefGoogle Scholar
  4. 4.
    Zissis G, Lambert JP, Marbehant P, et al. Protection studies in colostrum derived piglets of a bovine rotavirus vaccine candidate using human rotavirus strains for challenge. J Infect Dis. 1983;148:1061–8.PubMedCrossRefGoogle Scholar
  5. 5.
    Penelope HD. Rotavirus vaccines: an overview. Clin Microbiol Rev. 2008;21:198–208.CrossRefGoogle Scholar
  6. 6.
    Block SL, Vesikari T, Goveia MG, et al. Efficacy, immunogenicity and safety of a pentavalent human-bovine (WC3) reassortantrotavirus vaccine at the end of the shelf life. Pediatrics. 2007;119:11–8.PubMedCrossRefGoogle Scholar
  7. 7.
    Mendoza AV, Bertozzi SM, Gutierrez JP, Itzler R. Cost effectiveness of introducing a rota virus vaccine in developing countries: the case of Mexico. BMC Infect Dis. 2008;8:103.CrossRefGoogle Scholar
  8. 8.
    Zaidi A, Awasthi S, de Silva HJ. Burden of infectious diseases in South Asia. Br Med J. 2004;328:811–5.CrossRefGoogle Scholar
  9. 9.
    Brown DW, Mathan MM, Mathew M, Martin R, Beards GM, Mathan VI. Rotavirus epidemiology in Vellore, South India: group, subgroup, serotype, and electrophore type. J Clin Microbiol. 1988;26:2410–4.PubMedGoogle Scholar
  10. 10.
    Ramani S, Kang G. Burden of disease & molecular epidemiology of group A rotavirus infections in India. Indian J Med Res. 2007;125:619–32.PubMedGoogle Scholar
  11. 11.
    Kang G, Green J, Gallimore CI, Brown DW. Molecular epidemiology of rotaviral infection in South Indian children with acute diarrhea from 1995–1996 to 1998–1999. J Med Virol. 2002;67:101–5.PubMedCrossRefGoogle Scholar
  12. 12.
    Cicirello HG, Das BK, Gupta A, et al. High prevalence of rotavirus infection among neonates born at hospitals in Delhi, India: predisposition of newborns for infection with unusual rotavirus. Pediatr Infect Dis J. 1994;13:720–4.PubMedCrossRefGoogle Scholar
  13. 13.
    Iturriza GM, Kang G, Mammen A, et al. Characterization of G10P [11] rotaviruses causing acute gastroenteritis in neonates and infants in Vellore, India. J Clin Microbiol. 2004;42:2541–7.CrossRefGoogle Scholar
  14. 14.
    Banerjee I, Ramani S, Primrose B, et al. Comparative study of epidemiology of rotavirus in children from a community-based cohort and a hospital in South India. J Clin Microbiol. 2006;44:2468–74.PubMedCrossRefGoogle Scholar
  15. 15.
    WHO Collaborative Study Team. Effect of breastfeeding on infant and child mortality due to infectious diseases in less developed countries: a pooled analysis. Lancet. 2000;355:1104.Google Scholar
  16. 16.
    Clemens J, Rao M, Ahmed F, et al. Breast feeding and the risk of life threatening rotavirus diarrhea: prevention or postponement? Pediatrics. 1993;92:680–5.PubMedGoogle Scholar
  17. 17.
    Esrey SA, Feachem RG, Hughes JM. Interventions for the Control of Diarrhoeal Diseases among Young Children: Improving Water Supplies and Excreta Disposal Facilities. Bull World Health Organ. 1985;63:757–72.PubMedGoogle Scholar
  18. 18.
    Victora CG, Bryce J, Fontaine O, Monasch R. Reducing Deaths from Diarrhoea through Oral Rehydration Therapy. Bull World Health Organ. 2000;78:1246–55.PubMedGoogle Scholar
  19. 19.
    Rose J, Hawthorn RL, Watts B, Singer ME. Public health impact and cost effectiveness of mass vaccination with live attenuated human rotavirus vaccine (RIX 4414) in India: model based analysis. BMJ. 2009;339:b3653.PubMedCrossRefGoogle Scholar
  20. 20.
    Griffiths UK, Clark AD, Mulholland KM. Introduction of rotavirus vaccine- getting it to communities at highest risk of mortality from diarrheal disease in the greatest challenge. BMJ. 2009;339:b3482.PubMedCrossRefGoogle Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2011

Authors and Affiliations

  • Sutapa Bandyopadhyay Neogi
    • 1
    • 2
    Email author
  • Habib Hasan
    • 1
  • Kabir Sheikh
    • 1
  • Sanjay Zodpey
    • 1
  1. 1.Department of Community Medicine, Maternal and Child HealthIndian Institute of Public Health (IIPH)DelhiIndia
  2. 2.Indian Institute of Public Health (IIPH), Public health foundation of India (PHFI)GurgaonIndia

Personalised recommendations