Status of implementation of rotavirus vaccination in the Americas

In Latin America and the Caribbean (LAC), rotavirus diarrhea causes approximately 15,000 deaths, 75,000 hospitalizations, 2 million clinic visits, and 10 million cases of rotavirus diarrhea annually. Two safe rotavirus vaccines are available that are effective in preventing severe illness. To date, seven countries in Latin America, Brazil, Ecuador, El Salvador, Panama, Mexico, Nicaragua, and Venezuela have introduced the rotavirus vaccine. For successful rotavirus vaccine introduction, the lessons learned re-emphasize the critical need for countries to have precise plans that will ensure that infrastructure capacity for program implementation. Most lessons identified come from the first countries to introduce this vaccine, and they relate to programmatic feasibility, including: cold chain; information systems for coverage monitoring; training and supervision; adverse event monitoring; vaccine supply management; and financial sustainability. The experiences shared among early adopters through different forums, have facilitated the vaccine introduction in other countries, and should serve to facilitate the introduction of other new vaccines. Regional networks, including rotavirus strain surveillance and adverse event monitoring, provide information that extend the knowledge base and provide useful evidence for decision-making. Countries actively participating in these networks have greater opportunities to discuss and improve their plans for new vaccine introduction and evaluate the impact of the intervention. The lessons learned support the strategic vision for new vaccine introduction in the Americas. This experience provides encouraging evidence that the rapid uptake of the rotavirus vaccine will continue, reaching the children who need it most.