Impact of dosing schedules on performance of rotavirus vaccines in Ghana

There is currently limited evidence regarding how the rotavirus vaccine dosing schedule might be adjusted to improve vaccine performance. We quantified the impact of the previously implemented 6/10-week Rotarix vaccine (RV1) in Ghana to the model-predicted impact for other vaccine dosing schedules across three hospitals and the entire country. Compared to no vaccination, the model-estimated median percentage reductions in rotavirus ranged from 28 to 85% and 12 to 71% among children <1 and <5 years old, respectively. The median predicted reductions in rotavirus for the whole country ranged from 57 to 66% among infants <1 year and 35 to 45% among children <5 years old. The 1/6/10- and 6/10/14-week schedules provided the best and comparable reductions in rotavirus compared to the original 6/10-week schedule. A third dose could prevent an additional 9 to 14% of deaths. An additional dose of RV1 might be an effective strategy to improve rotavirus vaccine impact, particularly in settings with low vaccine effectiveness.