Introduction of rotavirus vaccine

Introducing multiple vaccines in low- and lower-middle-income countries: issues, opportunities and challenges

Low- and lower-middle-income countries are faced with a large and increasingly complicated portfolio of vaccines to introduce into their national immunization programmes. Countries must also incorporate their vaccine introduction plans into donor-required assessments and multi-year plans. An international workshop and series of key informant interviews were conducted to explore the interest, opportunities and challenges for the proactive planning of multiple vaccine introduction within a single planning cycle and the underlying processes for planning the introduction of new vaccines. The study found limited experience with this proactive planning process in low-income countries and used the experience of two lower-middle-income countries in simultaneously introducing rotavirus and pneumococcal vaccines to highlight the importance of integrating the planning processes for new vaccine introduction into broader immunization systems planning and financing. The study's findings suggest that this strategy for vaccine introduction may have promise for accelerating the pace of new vaccine introduction. However, we also show that realizing these benefits will require improved logistic and financial planning activities and continued actions to resolve uncertainties in the relationships between donors, technical agencies, and the national immunization programmes.

Scope for rotavirus vaccination in India: revisiting the scientific evidence

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.