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Background <p>India 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.</p> Methods <p>We 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.</p> Results <p>Among 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%).</p> Conclusions <p>Rotavirus 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.</p>

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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

  • 期刊论文

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  • 发表日期：

    2026年3月14日

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  • Tintu Varghese,
  • Anupama Machathi,
  • Shainey Alokit Khakha,
  • Nayana P. Nair,
  • Reddy N. Samarasimha ,
  • Varsha Sudhir Chaudhary,
  • Namrata Kharat,
  • Prasanna Samuel,
  • Sidhartha Giri,
  • Venkata Raghava Mohan,
  • Gagandeep Kang

摘要

Background

India 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.

Methods

We 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.

Results

Among 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%).

Conclusions

Rotavirus 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.