Since the introduction of the rotavirus vaccine, infant deaths have decreased significantly worldwide, especially in the United States. But the virus is still a leading cause of death from diarrhea among children in certain parts of the world.

Rotavirus is a highly contagious virus that can cause severe diarrhea and vomiting, especially in infants. Before a vaccine was available, rotavirus was responsible for half a million child deaths each year, according to the Centers for Disease Control and Prevention (CDC).

Thankfully, rates have decreased significantly since 2006, when pharmaceutical manufacturers introduced the rotavirus vaccine to more than 100 countries. While rotavirus now causes few deaths in the U.S., it’s still responsible for more than 200,000 deaths worldwide, mainly in Africa, Oceania, and South Asia.

Keep reading to learn more about the number of deaths by rotavirus and the effect the vaccine has had on reducing serious illness and death from the virus.

Rotavirus symptoms

Rotavirus most commonly causes vomiting and watery diarrhea. Symptoms can last anywhere from 3 to 8 days. Other symptoms may include appetite loss and dehydration.

Dehydration in children from the rotavirus can cause the following symptoms:

  • decreased urination
  • dizziness upon standing
  • dry mouth/throat
  • lethargy or being unusually sleepy
  • not making tears when crying
  • severe fussiness

The introduction of the rotavirus vaccine in the U.S. dramatically reduced the number of child hospital visits due to the virus. The CDC estimates the vaccine prevents between 40,000 and 50,000 hospitalizations each year.

Despite the clear benefits, a 2018 research review found that vaccinations plateaued from 2013 to 2015, peaking at 73.2% of eligible-aged children. This is lower than the 80% goal set by the federal government.

Before the vaccine

Before the rotavirus vaccine introduction, nearly every child in the United States had a rotavirus infection by 5 years old, according to the CDC. The organization also shares that pre-vaccine, rotavirus led to more than 400,000 doctor visits and 55,000 to 70,000 hospitalizations among this age group.

The CDC also notes that between 20 and 60 deaths occurred among children under 5 each year due to rotavirus.

After the vaccine

In a 2018 review, researchers observed U.S. vaccination and illness rates from 2006 to 2017. They found that the vaccine reduced rotavirus-related hospitalizations by 80% and emergency department visits by 57%.

In studies of vaccine effectiveness, which looked at whether those vaccinated against rotavirus needed hospitalization or serious care, the vaccine was about 84% effective at preventing such occurrences.

Besides considerations for overall health, the rotavirus vaccine has also reduced healthcare costs. Experts estimate the rotavirus vaccine has reduced healthcare costs in the United States by $121 to $231 million annually.

After successful introductions in Europe and the Americas, the World Health Organization recommended in 2009 that all countries include the rotavirus vaccine in their regular infant immunization programs. Now available in more than 100 countries, the vaccine has led to a 40% decrease in hospital admissions for rotavirus in children younger than 5 years old. Global rotavirus-related deaths have also decreased by 25%.

But the vaccine may not be as effective everywhere in the world as it is in the U.S. A 2020 review found that its effectiveness was 86% for countries with low infant death compared with 63% for countries with high infant death.

In 2016, rotavirus was still the leading cause of diarrheal death among children worldwide, contributing to almost 129,000 deaths among children ages 5 and under. About half of all such deaths occur in four countries:

  • Democratic Republic of the Congo
  • India
  • Nigeria
  • Pakistan

A 2018 report estimated that the rotavirus vaccine saved 28,000 lives in 2016, but more widespread use could have saved 83,200 more.

Who is most at risk of rotavirus?

Children under 3 years old are most at risk of rotavirus. Severe disease is most likely in unvaccinated children ages 3 months to 3 years. Others at increased risk of rotavirus may include:

  • adults who care for children, such as at a day care
  • older adults
  • those with weakened immune systems, such as from medical conditions, including HIV or cancer

You may not always think of a viral illness resulting in diarrhea as life threatening. But severe diarrhea can cause dehydration, electrolyte imbalances, and bleeding in young children.

Because children’s bodies are smaller, they can’t tolerate the loss of fluids as well as adults may be able to. Losing electrolytes, like sodium and potassium, can also affect their heart rhythms and brain functioning. All of these effects can be life threatening without prompt treatment.

People can commonly pass on the rotavirus by hand-to-mouth contact. You can get an infection if you touch a contaminated object or surface and then touch your mouth. You can also get it by eating contaminated food.

You shed the virus when you poop. The CDC notes that this is how the virus gets into the environment. Most people develop an infection by coming in contact with infected poop.

You can help prevent the spread of rotavirus by washing your hands thoroughly after cleaning and disposing of a child’s dirty diaper and disinfecting food preparation or eating areas and areas where stool or urine may have touched after changing diapers.

But more than good hygiene is needed. Vaccination of eligible-aged children can be the best way to prevent rotavirus.

Vaccination can also offer indirect protection to those who may not be as vaccinated, such as older adults. Because vaccinated children tend to be less likely to develop a severe infection, they also tend to be less likely to pass it on to older adults and their caregivers.

Rotavirus remains a leading cause of infant hospitalization and death worldwide. But the introduction of the rotavirus vaccine has significantly reduced the number of severe cases of this infection, especially in the United States. Even so, less than 80% of eligible U.S. infants receive the vaccine, falling short of national goals.

Because the vaccine isn’t available to people older than 8 months, children getting vaccinated may help protect older adults and others at risk of serious illness from infection. If you have an infant, talk with your child’s doctor about the rotavirus vaccine.