Comparison of Clinical Profiles and Trends of Rotavirus Gastroenteritis in the Prevaccine and Postvaccine Periods Among Children Aged Under 5 Years in the Western States of Gujarat and Maharashtra, India.

objectivesTo assess the prevalence of rotavirus gastroenteritis (RVGE) and compare the clinical profile and genotypic distribution in the prevaccine and postvaccine periods among children aged < 5 y.

methodsA comparative analysis was conducted at the same four sites over two time periods: prevaccine (2013–2016) and postvaccine (2021–2023) introduction. Children aged < 5 y with acute gastroenteritis, admitted to the sentinel hospitals, were included in this study. Stool samples were tested for rotavirus at reference laboratories.

resultsThe prevalences of RVGE were 30.5% (723/2367) and 19.1% (80/420) in the prevaccine and postvaccine periods, respectively. A higher occurrence of RVGE was observed in the winter months in both the studies, whereas the presence of vomiting, fever, and G3P[8] strains were more prevalent in the postvaccine period. Among children aged 6–23 mo, a significant reduction of RVGE (odds ratio: 0.53, 95% confidence interval: 0.41–0.69; p < 0.001) and the G1P[8] strain were noted during the postvaccine period.

conclusionsA significant reduction in the absolute positivity percentage and proportion of RVGE, particularly among the 6–23-mo age group, suggests protection by the rotavirus vaccine. However, the shifts in strain predominance, especially the increased presence of G3P[8] and G2P[4], reaffirm the need for continued surveillance to monitor evolving genotypic patterns. These findings reinforce the vital role of ongoing immunization efforts to reduce the burden of severe diarrheal illness among young children.