Ready to Measure Impact? The Introduction of Rotavirus Vaccine in India.

In the past few years, two live attenuated, orallyadministered rotavirus vaccines were available for Indian children immunized by pediatricians in private practice – a monovalent human rotavirus vaccine [RV1; Rotarix (GSK Biologicals, Rixensart, Belgium)] and a pentavalent bovine-human reassortant vaccine [RV5; RotaTeq (Merck and Co, Inc, Pennsylvania)] [1,2]. Initially, in 2006, these vaccines were recommended by the World Health Organization (WHO) for countries in regions where clinical trial data were available, but in 2009 – following additional clinical trials in low income countries – the WHO extended its recommendation to include rotavirus vaccines in the routine immunization programs in all countries, and particularly in those with high child mortality due to diarrhea [3]. However, the cost of the vaccines was high, and with a birth cohort of 27 million, it seemed challenging to consider the introduction of a rotavirus vaccine for routine use in India. Yet today, a vaccination program has begun, initially for four states, but with plans to cover the entire country rapidly.