It is estimated that 0.6 million children die annually due to rotavirus diarrhea under the age of 5 years world over. 90% of these deaths occur in developing countries. Western data suggests that current rotavirus vaccines have 85-95% efficacy against severe rotavirus gastroenteritis (RVGE). There are concerns while using the same in developing countries. Data from African trial has shown 76% efficacy against severe RVGE. Efficacy in malnourished children has been found to be 73% as against 74% in well nourished children. Co-administration of oral polio vaccine has shown no interference with rotavirus vaccine in study done in Bangladesh. European study showed efficacy of 86% with current rotavirus vaccines in breast-fed babies which is similar to 91% efficacy in top fed babies. Last concern is affordability of rotavirus vaccine in developing countries which is partially addressed by support from GAVI, which has pledged to support 3 life saving vaccines like rotavirus vaccine for 75 GAVI eligible countries by providing vaccine at US$ 0.15-0.30 per dose till 2015 and even beyond. By including current rotavirus vaccines in the national immunization program of these developing countries there is a potential to save 0.3 million children from dying due to severe RVGE every year.