Rotavirus Vaccine Demand in Pakistan.

Dear Editor-in-Chief

With the advent effort of Edward Jenner, vaccination now became the global phenomenon (1). The World Health Organization (WHO) had initiated the recommended Expanded Programme on Immunization (EPI) in Pakistan in the year of 1978. At start other than tetanus toxoid vaccine, which focused mainly pregnant women to protect the newborn from neonatal tetanus, eight preventable diseases namely tuberculosis, poliomyelitis, diphtheria, pertussis, tetanus and measles were exclusively for the children before their second birthday. FDA introduced a new tetravalent vaccine in 2006. This combination has substituted the previous individually available hepatitis B vaccine including DTP3 (diphtheria, tetanus & pertussis). After two years in 2008, the pentavalent (DTP-Hep B-Hib) vaccine with the addition of the new Hib vaccine has been integrated into EPI. Pneumococcal vaccine (PCV) became the ninth vaccine for EPI-regime in 2012 (2).

Rotavirus gastroenteritis is the second most common preventable cause of mortality and morbidity among under the age of 5 yr children in developing countries like Pakistan. Fortunately, Food and Drug Administration (FDA) have approved Rotavirus vaccine and it is available as first dose at the age of 2 months, second dose at 4 months and potential third dose at 6 months, if necessary. Nearly, all the children got this vaccine have almost never contracted sever form of rotavirus gastroenteritis. However, unfortunately it has yet to be incorporated in the EPI schedule of Pakistan. Government is also feeling content to cater only the nine infectious diseases, however, not successful. Other vaccines could be given along with other EPI vaccines safely and confidently (3).

In the first 12 months of age, nearly all rotavirus vaccines have established to prevent more than 91% sickness related to rotavirus infections (4). In short, evidence has proven that rotavirus vaccine is a highly effective, efficacious, efficient and economic especially in preventing infective diarrhea due to Rotavirus, globally (5). By including Rotavirus vaccination in EPI regime, hoped that it would decrease morbidity, diminish mortality, shrink the number of hospitalizations and have a optimistic economic impact on healthcare system in near future (6). Hence, it is highly suggested that it should be included in the EPI program of Pakistan.