Rotavirus is the most common cause of severe diarrheal disease in children worldwide. A recent study determined that 37 percent of the 578,000 childhood diarrheal deaths in 2013 were due to rotavirus, for a total of 215,000 rotavirus deaths globally. More than 90 percent of these deaths occurred in developing countries. Rotavirus disease cannot be treated with antibiotics or other drugs, and most children are at risk of infection regardless of hygiene practices or access to clean water. Vaccination is the best way to protect children from rotavirus and the deadly dehydrating diarrhea that it can cause. In 2009, the World Health Organization recommended that all countries include rotavirus vaccines in their national immunization programs. Currently, two vaccines against the disease are globally available, four vaccines are available in national markets only, and several more are in development.
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- Rotavirus is the most common cause of severe diarrheal disease in children worldwide. A recent study determined that 37 percent of the 578,000 childhood diarrheal deaths in 2013 were due to rotavirus, for a total of 215,000 rotavirus deaths globally. More than 90 percent of these deaths occurred in developing countries.
- Rotavirus is found in all countries. Regardless of hygiene practices or access to clean water, nearly every child in the world is at risk of infection with rotavirus before the age of five years.
- In young children, rotavirus disease is characterized by diarrhea, vomiting, fever, and severe dehydration. In fatal cases, death is caused by severe dehydration due to rotavirus infection.
- Rotavirus disease cannot be treated with antibiotics or other drugs. Rehydration therapy is an important part of treating dehydration due to diarrheal diseases, including rotavirus.
- Vaccination is the best way to prevent severe rotavirus illness, particularly in settings where access to medical care is limited or unavailable.
- There are currently two globally available vaccines against rotavirus: Merck’s RotaTeq® and GlaxoSmithKline’s Rotarix®. Studies of these vaccines have demonstrated their safety and efficacy among children in every region of the world. Clinical efficacy trials in Africa and Asia found that the vaccines dramatically reduced severe disease among infants in developing countries, where the majority of rotavirus deaths occur.
- There are four orally administered rotavirus vaccines licensed for national markets only: ROTAVAC®, manufactured by Bharat Biotech, was licensed for use in India in 2014; ROTASIIL®, manufactured by Serum Institute of India, Pvt. Ltd., was licensed for use in India in 2016; Rotavin-M1®, manufactured by the Center for Research and Production of Vaccines, was licensed for use in Vietnam in 2007; and Lanzhou Lamb Rotavirus Vaccine, manufactured by the Lanzhou Institute of Biological Products, was licensed for use in China in 2000.
- The World Health Organization recommends that rotavirus vaccines be included in every country’s immunization program.
- To date, nearly 100 countries have introduced rotavirus vaccines in their national immunization programs. Gavi, the Vaccine Alliance, a global health partnership that works to increase access to vaccines, is supporting the introduction of rotavirus vaccines in many of the world’s poorest countries. More than 45 countries have introduced rotavirus vaccines with Gavi’s support.
- Scientific studies show that rotavirus vaccines are making a major public health impact. Swift and significant declines in hospitalizations and deaths due to rotavirus and all-cause diarrhea have been observed in many of the countries that have introduced rotavirus vaccines into their national immunization programs. In some countries where rotavirus vaccines have been introduced, researchers are finding significant reductions in rotavirus diarrhea hospitalizations in unvaccinated adults and children, suggesting the benefits of rotavirus vaccines extend beyond infants and provide indirect protection to unvaccinated children and adults by reducing spread of the virus (an effect called herd immunity).
- While current manufacturers play an important role in meeting the global demand for the existing vaccines, additional vaccine options and manufacturers are critical to ensuring a sustainable, affordable supply. Several manufacturers are developing new rotavirus vaccines, including many in emerging countries.
- Rotavirus vaccines are an important part of an integrated prevention and treatment strategy to control diarrheal disease. Other elements of this strategy include oral rehydration therapy; zinc treatment; exclusive breastfeeding; proper nutrition; safe water; and improved sanitation and hygiene practices.
Diarrheal disease is a leading cause of death in children in developing countries. In addition to rotavirus, there are many other pathogens that contribute to morbidity and mortality from diarrheal disease, including Shigella and enterotoxigenic Escherichia coli (ETEC), the leading bacterial causes of diarrhea. Learn more about Shigella and ETEC.
- Armah GE, Sow SO, Breiman RF, et al. Efficacy of Pentavalent Rotavirus Vaccine Against Severe Rotavirus Gastroenteritis in Infants in Developing Countries in Sub-Saharan Africa: A Randomised, Double-Blind, Placebo-Controlled Trial.
- Madhi SA, Cunliffe NA, Steele D, et al. Effect of Human Rotavirus Vaccine on Severe Diarrhea in African Infants.
- PATH. Rotavirus Vaccine Impact Data.
- Tate JE, Burton AH, Boschi-Pinto C, Parashar UD. Global, Regional, and National Estimates of Rotavirus Mortality in Children <5 Years of Age, 2000–2013.
- United Nations Children's Fund. Committing to Child Survival: A Promise Renewed—Progress Report 2013.
- World Health Organization. Rotavirus Vaccines: WHO Position Paper - January 2013.
- Zaman K, Dang DA, Victor JC, et al. Efficacy of Pentavalent Rotavirus Vaccine Against Severe Rotavirus Gastroenteritis in Infants in Developing Countries in Asia: A Randomised, Double-Blind, Placebo-Controlled Trial.
Page last updated: August 2019.
Photo: PATH/Mike Wang.