Impact of Rotavirus Vaccine on Malnutrition Among Children in India—Breaking Vicious Cycle of Diarrhea: A Cross-Sectional Analytical Study

Abstract Background Malnutrition among children remains a significant public health concern in countries with stunting, wasting, and underweight as key indicators. Rotavirus accounts for approximately 40% of moderate to severe diarrhea cases in children under five, highlighting the potential role of rotavirus vaccination in mitigating diarrhea-associated malnutrition. This study investigated the association between the Rotavirus vaccine (RVV) and malnutrition among children in India. Methods The study examined data from the National Family Health Survey-5. The sample included 67,369 children aged 12 to 35 months. Outcomes included stunting, underweight, and wasting, along with their severe form of malnutrition. Adjusted regression, sensitivity analyses, and Inverse Probability Weighting Regression Adjustment assessed the association between receiving RVV and malnutrition. Results Children receiving all three RVV doses had a lower prevalence of stunting (37% vs 41%), underweight (28% vs 33%), and wasting (17% vs 20%) compared to the unvaccinated. Full RVV coverage was significantly associated with reduced odds of stunting (aOR: 0.88; 95% CI: 0.85–0.92), underweight (aOR: 0.86; 95% CI: 0.83–0.89), and wasting (aOR: 0.85; 95% CI: 0.82–0.89). Conclusion Receiving RVV is associated with a reduced risk of malnutrition in children, highlighting the indirect effect (Herd Immunity) and the role of the vaccine beyond preventing diarrheal disease.