Widespread introduction of rotavirus vaccines has led to major reductions in the 
burden of rotavirus gastroenteritis worldwide. Vaccine effectiveness is 
diminished, however, in low income countries, that harbour the greatest burden 
of rotavirus attributed morbidity and mortality. Indirect effects of rotavirus 
vaccine (herd immunity and herd protection) could increase population level 
impact and improve vaccine cost effectiveness in such settings. While rotavirus 
vaccine indirect effects have been demonstrated in high and middle income 
countries, there are very little data from low income countries where force of 
infection, population structures and vaccine schedules differ. Targeted efforts 
to evaluate indirect effects of rotavirus vaccine in low income countries are 
required to understand the total impact of rotavirus vaccine on the global 
burden of rotavirus disease.