Rotavirus disease and vaccines in India: A tremendous public health opportunity

Rotavirus disease and vaccines in India: A tremendous public health opportunity ଝIn March 2014, The Lancet reported the successful results of the efficacy and safety trial of 116E, the first Indian-manufactured rotavirus vaccine to complete phase 3 clinical testing [1].In a multicenter study conducted in three geographically and culturally diverse cities of India -Delhi, Pune, and Vellore -despite intensive health care provision which may have modified the severity of disease, the 116E vaccine showed efficacy comparable to that of two internationally licensed rotavirus vaccines manufactured by Merck and Co. and GlaxoSmithKline.Several other indigenously manufactured rotavirus vaccines are in development in India, some of which are in late stages of clinical testing.With an effective, indigenously produced rotavirus vaccine on the near-term horizon, India, which singularly accounts for almost one fifth of the world's burden of rotavirus deaths in children [2], is poised to have a new tool in the arsenal of interventions to reduced morbidity and mortality from childhood diarrhea.To help assess the public health value of the vaccine, understanding the current rotavirus disease burden and epidemiology, circulating strains, and economic burden of rotavirus in India is important.This supplement contains papers summarizing the most up-to-date data on these issues.In addition, the supplement addresses areas relevant for postintroduction monitoring of rotavirus vaccine, including potential safety concerns associated with other rotavirus vaccines such as intussusception, a condition in which one portion of the bowel telescopes into another causing a blockage.Finally, this supplement contains papers looking at the performance of rotavirus vaccines, both the indigenous and internationally available vaccines, in India and explores strategies to improve vaccine performance.This collection of papers will help provide a complete picture of rotavirus disease in India and the potential for a rotavirus vaccination program, and also set the platform to assess the impact of vaccines post-introduction. Rotavirus disease burden in IndiaRotavirus persists as a major cause of severe acute diarrhea in Indian children.By 5 years of age, an estimated 1 out of every ଝ The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.