Rotavirus vaccine support

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Rotavirus vaccine coverage in Gavi-supported countries rose by 5 percentage points between 2016 and 2017

Rotavirus Ghana

In 2012, Ghana was the first Gavi-supported country to introduce rotavirus and pneumococcal vaccines at the same time. Credit: Gavi/2012/Doune Porter.


Rotavirus vaccines protect against the deadliest form of diarrhoea in young children. One of Gavi's main objectives is to ensure access to these vaccines in the countries that need them most.

By the end of 2017 we had funded rotavirus vaccine introductions in 43 countries. Thanks to our support, these countries have immunised more than 76 million children against rotavirus. Coverage of a full course of the vaccine across Gavi-supported countries increased by 5 percentage points between 2016 and 2017 to reach 28% – on a par with the global average.

The introduction in Pakistan’s Punjab province in January 2017 reached 20% of the national population, paving the way for the planned roll-out across all provinces in 2018. Another six countries – Afghanistan, Benin, Kyrgyzstan, Lao People’s Democratic Republic, Nepal and the Solomon Islands – were approved for rotavirus vaccine support.


According to a study in 116 countries, rotavirus vaccination is cost-effective. This is particularly true in low- and lower-middle-income countries with high child mortality.

Researchers found that without rotavirus vaccination, in 2010 there would have been:

  • 23 million outpatient cases
  • 3.3 million inpatient cases
  • over 290,000 deaths
  • US$ 987 million spent on treatment costs.1 

Using rotavirus vaccines in Gavi-supported countries can save US$ 68 million in treatment costs every year.2 

1 Palermina-Caicedo A, De la Hoz-Restrepo F, Alvis-Guzman N. Epidemiological and Economic Impact of Monovalent and Pentavalent Rotavirus Vaccines in Low and Middle Income Countries: A Cost-Effectiveness Modeling Analysis. The Pediatric Infectious Disease Journal, April 28 2015.
2 Atherly DE, Lewis KDC, Tate J, Parashar UD, Rheingans, RD. Projected health and economic impact of rotavirus vaccination in GAVI-eligible countries: 2011-2030. Vaccine. 2012;30(Suppl 1):A7–A14).

Rotavirus is the leading cause of deadly diarrhoea in children worldwide


Rotavirus is a virus that can cause inflammation of the stomach and intestines. Symptoms include severe watery diarrhoea, often with vomiting, fever, and abdominal pain. Infants and young children are most likely to get rotavirus disease.

In serious cases, children risk dying from dehydration. More than 500,000 children under five years die from diarrhoeal disease each year.

Over 95%1 of rotavirus deaths are in low-income countries in Africa and Asia. In these countries, access to diarrhoea treatment is often limited or unavailable.


Unlike other types of diarrhoea, improving hygiene does not prevent rotavirus infection. Also, antibiotics and other drugs cannot cure rotavirus.

Although it can be treated with proper healthcare, this is often lacking in developing countries. As a result, vaccination is the best way to prevent rotavirus illness and death.

Map of the global burden of rotavirus diarrhoeal disease

Rotavirus global disease burden  


WHO recommends that all countries introduce rotavirus vaccines in their national programmes. This is particularly important in South and Southeast Asia and sub-Saharan Africa.

Recent studies show significant impact of rotavirus vaccines. Following introductions of the vaccine, diarrhoeal deaths in young children fell by 19–43% in Bolivia, 43–55% in Mexico and 57–64% in Venezuela.2 

Increasing access to these vaccines in Gavi-supported countries can prevent more than 2.4 million deaths by 2030.3 


Short-term supply constraints resulted in three rotavirus vaccine introductions being delayed, either entirely or partially, in 2017. While prompt action on the part of the Alliance mitigated the impact of these shortages, we continue to closely monitor the supply situation.

1 Tate JE, Burton AH, Boschi-Pinto C, et. al. 2008 estimate of worldwide rotavirus-associated mortality in children younger than 5 years before the introduction of universal rotavirus vaccination programmes: a systematic review and meta-analysis. The Lancet Infectious Diseases. 2012;12(2):136–141.
2 Rotavirus vaccine impact. PATH website. Available at: Accessed 21 September 2016.
3Vaccine, Volume 30, Supplement 1, 27 April 2012: ‘Rotavirus vaccines for children in developing countries : Understanding the science, maximising the impact, and sustaining the effort’, Kathleen M. Neuzil, Umesh D. Parashar, A. Duncan Steele.

Gavi offers support for developing countries to introduce rotavirus vaccines


Gavi opened a funding window for rotavirus vaccines in Europe and Latin America in 2007. This was only a year after the USA and other high-income countries introduced the vaccine.

In 2009, WHO made a recommendation for universal rotavirus vaccination. Following this decision, Gavi started to offer this type of support worldwide. This allowed for countries in Africa and Asia, where most rotavirus deaths occur, to introduce the vaccine.

We fund the rotavirus vaccine itself, as well as a one-time grant to cover introduction costs.

Map of countries approved for Gavi's rotavirus vaccine support



WHO emphasises the need to integrate rotavirus vaccine with other interventions.

In 2014, Bangladesh, India and Zambia piloted integrated programmes against pneumonia and diarrhoea. The pilots were part of the Integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea.


Gavi supported the Rotavirus Vaccine Program (RVP), which ran from 2003 until 2008. RVP was a partnership between PATH, WHO and the U.S. Centers for Disease Control and Prevention (CDC).

The aim was to make rotavirus vaccines available where they were needed most, as fast as possible. It conducted clinical trials to show the safety and efficacy of the vaccines. These laid the groundwork for WHO’s recommendation for universal introduction.

Proof of concept

WHO based its 2009 recommendation on three studies in Africa and Asia:

  • Clinical study in Asia (Bangladesh and Vietnam). The vaccine reduced severe rotavirus disease by 51% during the first year of life. This is when children are at greatest risk of diarrhoea-related illness and death.1  
  • Clinical study in sub-Saharan Africa (Ghana, Kenya and Mali. Vaccination prevented 64% of severe rotavirus disease during the first year of life.2  
  • Clinical study in South Africa and Malawi. Rotavirus vaccine reduced severe rotavirus disease by 61% during the first year of life.3 

1 Zaman K, Dang DA, Victor J, 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. The Lancet. 2010;376(9741):615-623.
2 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. The Lancet. 2010;376(9741):606–614.
3 Madhi SA, Cunliffe NA, Steele D, et al. Effect of human rotavirus vaccine on severe diarrhoea in African infants. New England Journal of Medicine. 2010;362(4):289–298.
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