Uganda switches from Rotarix rotavirus vaccine to Rotasiil: Introducing a 3-dose Rotavirus vaccine schedule into the routine immunization program, March 2024

Background 

Uganda introduced the Rota Virus Vaccine (Rotarix) a 2 dose schedule into the RI schedule in June 2018 and the prevalence of Rota virus diarrhoea in children < 5 years has since greatly reduced (1). However, global supply challenges with the Rota virus vaccine in 2022 through to 2023 have necessitated the switch to a new formulation to ensure that children continue to be protected from Rotavirus disease (2).

Uganda made a decision to switch to Rotasiil type of rotavirus vaccine in March 2024. This is in a bid to reduce missed opportunities and ensure that infants continue to be protected from rotavirus disease. This vaccine follows a three-dose schedule administered at 6, 10, and 14 weeks of life.

Rationale for the revised scheduling and administration of the rotavirus vaccine

The World Health Organization recommends that the rotavirus vaccine series for each child be completed with the same product (brand of the vaccine) whenever possible.  However, vaccination should not be deferred or restarted because the product used for a previous dose is not available. In these situations, the series should be completed with any available licensed product (3).

Key instructions for health service providers

Accordingly, the ministry of health wishes to guide health providers as follows:

If any dose in the series includes Rotasiil-Liquid, a total of 3 doses of rotavirus vaccine should be given to ensure the infant is fully immunized.  A child who has received two doses of Rotarix vaccine is not supposed to receive a 3^rd dose of Rotasiil (Table 1).