Has Ghana’s Rotavirus Vaccine Switch Met Programmatic Expectations? an Analysis of National Surveillance Data; 2018-2022

Abstract Introduction Ghana introduced a two-dose schedule rotavirus vaccine, Rotarix® into childhood immunization in 2012 but switched to three-dose schedule vaccine, Rotavac® in 2020 on account of programmatic advantages offered by the latter, including lower cost per fully immunized child, and lower cold chain volume requirement. The objective of the study was to assess the effect of the vaccine switch on the trends of rotavirus vaccine uptake and health facility outpatient attendance (OPD) due to diarrhoea, among children aged 1-11 months. Methods A retrospective analysis was conducted on childhood immunization and diarrhoea surveillance data for 2018-2022. The uptake of the different rotavirus vaccine products, and the proportion of health facility outpatient attendance (OPD) attributed to diarrhoea, respectively, were compared between the pre- and post-switch study periods. Results The uptake of rotavirus vaccine was sustained following the switch. There were no significant differences in the vaccination coverages (rota1, Rotarix® coverage [94.3%] versus rota1, Rotavac® coverage [95.3%], p=0.757; rota2, Rotarix® coverage [91.3%] versus rota2, Rotavac® coverage [92.7%], p=0.789). The proportions of health facility OPD attendance due to diarrhoea were comparable (pre-switch [12.4%] versus post-switch [12.1%]: p=0.838). Conclusion Ghana’s rotavirus vaccine switch yielded expected programmatic benefits without any untoward effects. The trends of vaccine uptake and reduction in diarrhoea morbidity were sustained. The experiences and lessons from the rotavirus vaccine switch are vital for potential switches for other vaccines in the current immunization schedule to mitigate the annual vaccine expenditure.