Since its discovery 40 years ago, rotavirus (RV) is considered to be a major 
cause of infant and childhood morbidity and mortality particularly in developing 
countries. Nearly every child in the world under 5 years of age is at the risk 
of RV infection. It is estimated that 90% of RV-associated mortalities occur in 
developing countries of Africa and Asia. Two live oral vaccines, RotaTeq (RV5, 
Merck) and Rotarix (RV1, GlaxoSmithKline) have been successfully deployed to 
scale down the disease burden in Europe and America, but they are less effective 
in Africa and Asia. In April 2009, the World Health Organization recommended the 
inclusion of RV vaccination in national immunization programs of all countries 
with great emphasis in developing countries. To date, 86 countries have included 
RV vaccines into their national immunization programs including 41 Global 
Alliance for Vaccines and Immunization eligible countries. The predominant RV 
genotypes circulating all over the world are G1P[8], G2P[4], G3P[8], G4P[8], and 
G9P[8], while G12[P6] and G12[P8] are emerging genotypes. On account of the 
segmented genome, RV shows an enormous genetic diversity that leads to the 
evolution of new genotypes that can influence the efficacy of current vaccines. 
The current need is for a global RV surveillance program to monitor the 
prevalence and antigenic variability of new genotypes to formulate future 
vaccine development planning. In this review, we will summarize the previous and 
recent insights into RV structure, classification, and epidemiology and current 
status of RV vaccination around the globe and will also cover the status of RV 
research and vaccine policy in Pakistan.