ArticleVirology journal2026
Molecular epidemiology of rotavirus causing diarrhea among under-five children after the introduction of rotavirus vaccines, Rotavac and Rotasiil, into the national immunization program of India.
Article in Virology journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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11 authors.
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Abstract
backgroundIndia was among the first Southeast Asian countries to introduce rotavirus vaccines (Rotavac and Rotasiil) into its Universal Immunization Programme (UIP). Both showed efficacy in trials and protection against multiple genotypes, though concerns remain about cross-protection and strain selection.
methodsWe leveraged multicentric surveillance studies to assess the impact of vaccination on circulating rotavirus strains. From 2016 to 2023, hospital-based diarrheal surveillance enrolled children under five hospitalized with acute watery diarrhea. Stool samples were tested by rotavirus enzyme immunoassay (EIA), and positives were genotyped.
resultsAmong 27,862 samples, 6755 (24·2%) were rotavirus EIA positive, with the highest positivity in eastern and northeastern regions. Positivity declined from 31·2% to 17·5% over the study period, compared to 37% before vaccine rollout. Genotype distribution was broadly consistent across regions, dominated by G3P[8] (44·7%), G1P[8] (14·7%), G2P[4] (14·1%), and G1P[6] (4·5%). Mixed infections occurred in 13·9%. G12P[8] was frequent in the northeast. Post-vaccine introduction, G3P[8] and G2P[4] increased while G1P[8] declined. Genotype patterns differed by vaccine type: G2P[4] was more common at Rotasiil sites (30·9%) than Rotavac sites (10·2%), while mixed infections were lower at Rotasiil sites (7·8%) compared to Rotavac sites (15·3%).
conclusionsRotavirus vaccination significantly reduced disease burden among under-five children in India. G3P[8] remained consistently dominant across regions, vaccine types, and years. Regional and vaccine-specific differences were evident, but trends suggest natural viral evolution may outweigh vaccine-driven selection. Sustained surveillance is essential to detect emerging strains and ensure long-term vaccine effectiveness.
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