The results presented here are useful for policy analysis, given the paucity of data on the interventions’ effect size across different subsets of the population: at the state level, in the rural and urban populations, and across the wealth distribution. Additional research is needed to introduce an infectious disease model into the ABM used here and to take into account the state fixed effects. We thank Ashvin Ashok for selleck products his research assistance. Conflicts of interest: None declared. Funding: This work was funded by the Bill and Melinda Gates Foundation through the Disease Control Priorities project at the University of Washington (grant no. 720165), Grand Challenges
Canada through the Saving Brains project, and Johns Hopkins University (purchase order no. 2002067649) through the cost-effectiveness of rotavirus vaccination in India grant. The funders had no role in study design, writing the
report, the decision to submit, or data collection, analysis, and interpretation. “
“Rotavirus infection occurs worldwide in children under five years of age. The infection may remain asymptomatic, cause self-limiting watery diarrhea or may lead to acute gastroenteritis with fever, vomiting and severe dehydration that may at times be fatal. Bouts of vomiting associated with severe rotavirus gastroenteritis Vemurafenib mw (SRVGE) also pose a hurdle to the clinical management of these cases with oral rehydration salt and sugar solution. Furthermore, no antiviral medicine is currently considered as “standard of care” for SRVGE. On the other hand, disease burden and cost implications of rotavirus diarrhea have been estimated to be enormous  and . Due attention has therefore been paid by global health policy makers to tackle this challenging situation. Consequently, many countries have introduced rotavirus vaccines in their routine immunization program  and  after much deliberation. Key deciding
factors for introducing rotavirus vaccine Mephenoxalone in low-income countries have been cost of immunization, financial support from global alliance for vaccines and immunization (GAVI) and long-term sustainability of the program following withdrawal of external assistance . In India, the issue continues to be debated. While one group of discussants opines that India should  introduce the vaccine in her routine immunization program, others take a contrary stance . India’s national immunization program has evolved since the 1970s (Fig. 1) leading to the introduction of some vaccines and dropping of others based on scientific evidence and public health considerations. The rotavirus debate pivots on vaccine efficacy. While the indigenous Rotavac2 vaccine tested in India is being challenged , Rotarix3 and Rotateq4 – two vaccines that have undergone clinical trials in many developed and developing countries ,  and  – have not undergone trial in India. However, the latter two are currently available through the private health sector.