BACKGROUND: Rotavirus remains an important cause of gastroenteritis and has been 
associated with the hospitalization of 34 to 53 per 10 000 children <5 years of 
age in the United States annually from 2008 to 2012. Rotavirus vaccines are 
underused compared with other routine vaccines. We describe rotavirus vaccine 
coverage and missed opportunities for rotavirus vaccination.
METHODS: The National Immunization Survey is a random-digit-dial, 
population-based survey including US children 19 to 35 months of age. Children 
fully vaccinated for rotavirus were those who received 3 doses of the 
pentavalent rotavirus vaccine, 2 doses of the monovalent rotavirus vaccine, or 
≥3 doses of either vaccine type. Doses of the diphtheria-tetanus-acellular 
pertussis vaccine received from 6 weeks through 8 months and 0 days of age when 
the rotavirus vaccine was not received were considered missed opportunities for 
rotavirus vaccination according to Advisory Committee on Immunization Practices 
(ACIP) guidelines, and doses of the diphtheria-tetanus-acellular pertussis 
vaccine or measles-mumps-rubella vaccine from 6 weeks through 24 months and 0 
days of age were considered missed opportunities according to World Health 
Organization recommendations.
RESULTS: Of the 14 571 children included in the 2014 National Immunization 
Survey, 71% were fully vaccinated for rotavirus. Lower socioeconomic status 
increased the likelihood of being unvaccinated for rotavirus. Among the 14% of 
children who received no doses of the rotavirus vaccine, 72% had ≥1 ACIP-defined 
missed opportunities, and 83% had ≥1 World Health Organization-defined missed 
opportunities. Higher socioeconomic status increased the likelihood of having 
missed opportunities. Complete rotavirus vaccine coverage could be improved to 
81% if all missed opportunities within the ACIP-recommended schedule were 
addressed.
CONCLUSIONS: Addressing missed opportunities for rotavirus vaccination is 
essential to achieving the 80% rotavirus vaccine coverage target outlined by 
Healthy People 2020.