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September 2021
International Vaccine Access Center
Johns Hopkins Bloomberg School of Public Health

September 2021 Progress Update

Dear Colleagues,
We are over a year into battling the COVID-19 pandemic and efforts to achieve equitable vaccine coverage for all has become all the more important. New WUENIC immunization coverage estimates for 2020 were released in July, reflecting the anticipated backsliding in vaccination coverage as a byproduct of the pandemic. Rotavirus vaccine coverage, an already lagging routine immunization, was not exempt from this calamity.
Despite ongoing challenging times, small victories continue to be made to increase access to and advocacy for rotavirus vaccines globally. In July, an updated WHO position paper was published re-emphasizing the importance of rotavirus vaccination and incorporating updates such as the two rotavirus vaccines prequalified in 2018—ROTAVAC and ROTASIIL. We are also fortunate to have many exceptional experts, researchers, and advocates in the field, committing to preventing severe diarrheal disease—some of whom we continue to gather insights from through our ROTA Champions Series included in this update.
Mathu Santosham

Important Updates

Updated WHO rotavirus vaccine position paper

For the first time since the original output in 2013, the World Health Organization (WHO) released an updated rotavirus vaccine position paper on Friday, July 16, 2021. The position paper synthesizes new research, data, and developments in the field, such as the WHO pre-qualification of 2 additional rotavirus vaccines in 2018.

Of significance, the WHO remains staunch in the recommendation that rotavirus vaccines should be included in all national immunization programs and considered a priority, particularly in countries with high RVGE-associated fatality rates.

ROTAVAC 5D® now WHO prequalified

A new rotavirus vaccine from Bharat Biotech International Limited, ROTAVAC 5D®, was prequalified by the WHO on June 18, 2021. This liquid formulation of the existing frozen rotavirus vaccine, ROTAVAC®, comes with advantages such as being low dosage, not requiring a buffer, and having storage temperatures of standard refrigeration (2-8°C for up to 24 months). ROTAVAC 5D® adds factors of convenience and ease of implementation to the diversity of rotavirus vaccines available.

Professor Julie Bines among Eureka Prize finalist

ROTA advisor, Professor Julie Bines, has been selected as one of the 21 finalists in the Research and Innovation category at Australia’s leading science awards, the 2021 Australian Museum Eureka Prizes. Professor Bines is in the running for the Australian Infectious Diseases Research Centre Eureka Prize for Infectious Diseases Research for her contributions to rotavirus research and leadership in the development of the novel human neonatal rotavirus vaccine, RV3-BB.

Check out Professor Julie Bines' spotlight in our ROTA Champions Series.

Advocacy Initiative Updates

ROTA Champion Series

Our Champion Series aims to share the successes, challenges, and lessons of critical players in the fight against rotavirus. Read more on our new pieces featuring Dr. Fred Were of Kenya and Dr. Vesta Richardson of Mexico. Stay tuned for upcoming pieces on Dr. Michelle Groome of South Africa and Dr. Tony Nelson of Hong Kong.


Country Experiences Map

Our interactive map highlights success stories of countries that have introduced rotavirus vaccination, along with information on birth cohort, product, and coverage rates. Recently, we've added new stories on Uganda, Nicaragua, Rwanda, and Austria.

Are rotavirus vaccines a good investment for middle-income countries?

A new resource from PATH shows that even among non-Gavi eligible middle-income countries, rotavirus vaccination is likely to be highly cost-effective and beneficial.


The Health Benefits of Rotavirus Immunization for Children in Palestine: Results of a Vaccine Impact Analysis

In 2018 Palestine switched rotavirus vaccine products from ROTARIX® to ROTAVAC®. PATH worked with the Palestinian Ministry of Health to study health indicators in the two years following the switch in order to confirm the continued health benefits of the rotavirus immunization program. This brief presents the results of this impact analysis, which confirm the significant benefit that the rotavirus immunization program has had on reducing the disease burden caused by rotavirus in Palestine.

For more information, also read DefeatDD's blog on the analysis.


Based on the latest available estimates from 2020, the VIEW-hub maps are beginning to show the impact of the COVID-19 pandemic.

Upcoming Events

13th African Rotavirus Symposium 2021 

November 3-4, 2021 | Virtual

The 13th African Rotavirus Symposium (ARS), organised under the auspices of the African Rotavirus Network (AfrRN), will be a virtual event. 

The theme of the symposium is “Maintaining momentum for rotavirus immunization during the COVID-19 era.” The session topics include updates on Rotavirus Vaccines and Immunization in the context of COVID-19 pandemic and New Research Updates.

International Rotavirus Symposium 

Due to the ongoing COVID-19 situation, the 14th International Rotavirus Symposium has been postponed until August 17-19, 2022. It will bring together interested stakeholders to provide an update on new data and relevant research that will inform public health agendas related to prevention of rotavirus gastroenteritis.

New Research

Immunogenicity and safety of two monovalent rotavirus vaccines, ROTAVAC® and ROTAVAC 5D® in Zambian infants

PATH conducted a study of the newly WHO prequalified ROTAVAC 5D in Lusaka, Zambia to provide evidence of the vaccine’s performance in a high-burden population outside of India. Ultimately, data reported in this paper found that ROTAVAC 5D is safe and works just as well as ROTAVAC to generate a strong immune response in Zambian infants.

Read also DefeatDD's blog post on the study and its results.
Rotavirus gastroenteritis in children hospitalized in northeastern Poland in 2006-2020: severity, seasonal trends, and impact of immunization. 

Rotavirus vaccine was added to Poland's national immunization program just this year in 2021. This study aimed to summarize the epidemiology of acute gastroenteritis (AGE) in northeastern Poland prior to 2021 and to evaluate the effectiveness of voluntary, out-of-pocket rotavirus childhood vaccination on the incidence of rotavirus AGE. The study found rotavirus was the primary causative agent of AGE in children hospitalized in northeastern Poland during the study period, with data suggesting that universal immunization is key to achieving a significant reduction of rotavirus-associated diarrhea.

Impact of rotavirus vaccine introduction on rotavirus hospitalizations among children under 5 years of age - World Health Organization African Region, 2008-2018. 

Rotavirus is the leading cause of acute gastroenteritis (AGE) among children worldwide. Prior to rotavirus vaccine introduction, over one third of AGE hospitalizations in Africa were due to rotavirus. This paper describes the impact of rotavirus vaccines using data from the African Rotavirus Surveillance Network (ARSN). Findings detailed in this study show rotavirus vaccine introduction led to large and consistent declines in the proportion of hospitalized AGE cases that are positive for rotavirus. The study recommends that to maximize the public health benefit of these vaccines, efforts to introduce rotavirus vaccines to the remaining countries in the region and improve coverage should continue.

Evaluating the potential economic and health impact of rotavirus vaccination in 63 middle-income countries not eligible for Gavi funding: a modelling study

Middle-income countries (MICs) that are not eligible for funding from Gavi, the Vaccine Alliance, have been slow to adopt rotavirus vaccines. This modeling study aims to assess the potential economic and health impact of rotavirus vaccination in 63 MICs not eligible for funding from Gavi. Results of the study found that in most MICs not eligible for Gavi funding, rotavirus vaccination has high probability to be cost-effective with a favorable benefit-risk profile, providing policy makers with new evidence when making or revisiting decisions on the use of rotavirus vaccines in their respective countries.

Burden of rotavirus disease in young children in Iceland - Time to vaccinate?

Rotavirus vaccination is currently not offered to Icelandic infants, yet rotavirus infections pose a significant burden on young children, families, health care facilities and societies. This study aims to assess the burden of rotavirus acute gastroenteritis in young children in Iceland and determine the potential benefit of adding rotavirus vaccine to the Icelandic childhood immunization schedule. The analysis found rotavirus to cause significant disease burden in young children and although rarely life-threatening in high income countries, the costs for society are substantial. The authors conclude that inclusion of rotavirus vaccine in the national immunization schedule will reduce the disease burden and would be cost-saving in Iceland.

For Early-Career Professionals

Are you an early-career professional working on rotavirus and rotavirus vaccines, or know someone who is? Would you like to get involved in ROTA’s scientific, policy, and advocacy initiatives? We’d love to hear from you! 

Contact us!
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