## Most Commonly Missed Vaccine in Indian Immunisation Schedule **Key Point:** Rotavirus vaccine, though part of the NIS since 2006 and universally recommended by IAP, has the poorest coverage rates among routine vaccines due to: - Limited awareness among parents and healthcare workers - Perception that it is a "private" vaccine despite NIS inclusion - Logistical challenges in rural areas - Lack of strong enforcement mechanisms ### Coverage Data | Vaccine | Approximate Coverage (%) | Reason for Gap | | --- | --- | --- | | Rotavirus | 45–60 | Poor awareness, perceived as optional | | PCV | 70–75 | Better awareness, part of GAVI initiatives | | IPV | 85–90 | Strong polio eradication drive | | Hepatitis B | 90+ | Birth dose emphasis, high priority | ### Why Rotavirus Vaccine Matters **High-Yield:** Rotavirus causes: - 30–40% of all acute gastroenteritis hospitalisations in Indian children <5 years - Significant morbidity and mortality in low-resource settings - Preventable by 3-dose series at 6, 10, 14 weeks (oral live attenuated vaccine) **Clinical Pearl:** The 2-dose schedule (6 and 10 weeks) recommended by some private practitioners differs from the NIS 3-dose schedule; this confusion further reduces coverage. ### IAP vs. NIS Alignment Both IAP and NIS recommend rotavirus vaccination, but: - NIS provides it free at government facilities - Uptake remains low due to lack of visibility and community engagement - PCV and IPV have stronger advocacy and monitoring systems [cite:Park 26e Ch 7]
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