Globally, rotavirus is the leading cause of diarrheal disease and the second leading infectious killer of infants and children under five children each year. Around the world, nearly 10 percent of under-five deaths are due to severe diarrhea each year, according to the 2017 Global Burden of Disease data released this month. What makes this especially upsetting is the fact that diarrheal diseases caused by pathogens like rotavirus can often be prevented with vaccination and improvements in basic sanitation.

Rotavirus claimed up to 200,000 lives and caused many additional hospitalizations in 2015 alone. It spreads easily from infected to healthy children through contaminated hands and objects, and can be retained in the environment for months after it has been introduced. Thankfully, since the advent of rotavirus vaccination in 2008, there has been significant progress in reducing rotavirus-associated morbidity and mortality in countries using rotavirus vaccines.

The Sabin Vaccine Institute and partners hosted the 13th International Rotavirus Symposium during August 2018 in Minsk, Belarus. The three-day conference gathered 280 attendees from 54 countries to examine the results from new rotavirus vaccine trials and discuss childhood diarrheal illness, advances in immunology, vaccine safety, the factors that enable or inhibit vaccine introduction, and immunization financing. The biennial symposium provides an opportunity for science experts, policy makers and public health officials to come together and share new breakthroughs and developments in rotavirus prevention and vaccination.

Nations that have introduced the vaccine as a part of routine immunization have witnessed quick and significant decreases in severe diarrhea among young children. Nearly 100 countries have begun rotavirus immunization since 2008, but large gaps in coverage remain. The vast majority of annual deaths from rotavirus occur in low- and middle- income countries – approximately 57 percent of the world’s children still lack access to rotavirus vaccines.

With the potential to reduce the risk of infant death due to diarrhea by almost one third, it is essential to extend this life-saving vaccine to all children. But, research findings shared during the Symposium suggest that there is still a substantial need for additional strategies to improve vaccine coverage and equity, and immunization financing in low-income and Gavi-transitioning countries. Symposium presentations also shed light on emerging research in the rotavirus field, including heat stable rotavirus vaccine potential, herd immunity effects and vaccine trials. Good progress has been made in rotavirus research, but there needs to be an extended effort to reach and protect all children who need them with rotavirus vaccines.

Diarrheal disease is the third leading cause of death for children under five, so requires significant attention if we are to reach the sustainable development goals for under-five mortality by 2030. It is promising that new, young researchers are expressing interest in the impact of rotavirus on childhood mortality. Approximately 125 posters were submitted to the Symposium, many of which represented research by young authors or researchers from low- and middle-income countries. The symposium provided a unique opportunity for new rotavirus champions to meet and learn from the leading voices in the field, in addition to sharing their own contributions to the study of rotavirus.

The 13th International Rotavirus Symposium was hosted by the Sabin Vaccine Institute, the U.S. Centers for Diseases Control, PATH, ROTA Council, the Fogarty International Center at the U.S. National Institutes of Health, the Government of the Republic of Belarus, and the Bill & Melinda Gates Foundation. Sabin has been the organizing secretariat since 2004, hosting eight iterations of the meeting. We look forward to the next symposium in 2020 to see how much has changed in the fight against rotavirus.

Many of the presentations from this year’s symposium can be found on our website.