Rotavirus infection is a highly infectious public health concern among under-five children characterized mainly by diarrhoea, vomiting and fever spread through oral fecal route from contaminated water, food and objects. Diarrhoea ranks third among the common causes of mortality in Zambia among under-fives which accounts for about 9%. Statistics obtained at Ndola District Health Management Office revealed that in spite of high coverage of rotavirus vaccine, diarrhoea incidence had risen over the years

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Rotavirus infection is recognized as a major cause of non-bacterial gastroenteritis infection affecting the stomach and intestinal tract in infants and young children worldwide leading to diarrhoea and vomiting. Most of the children would have had rotavirus infection by the time they are five years old. The disease is highly contagious and unpredictable as it can lead to dehydration due to severe loss of body fluid and consequently to death. World Health Organization recommended the use of two vaccines, RotaTeq R and Rotarix TM to be used in countries with high diarrhoea related mortality in under-five children. In Zambia rotavirus vaccine (Rotarix TM ) was rolled out to other parts of the country in its immunization program on 27th November 2013 after a successful pilot study in Lusaka in 2012 to reduce on diarrhoea caused by rotavirus infection among under-five children which had caused 9% of deaths. The objectives for this study were to establish uptake of rotavirus vaccine among under-fives and factors that shaped its adoption and acceptability at community level in Ndola, Zambia. Study design was cross sectional analytic community based which was conducted from 1st March 2017 to 28th September 2017 to compare factors that contributed to its uptake. Sample size consisted of 380 respondents who were parents/guardians to under-five children aged 3 -36 months residing in two homogenous selected communities. Purposive sampling was used to select study sites and respondents. This paper used triangulation method of data collection which included checklist, structured interview schedule and discussion guide tools. Health Statistical Package for Social Science (SPSS) was used for quantitative data analysis and Atlas.ti for qualitative data obtained from Focus Group Discussions (FGD) using hermeneutics theoretical frames to identify linkages and associations of variables. Results have shown that majority (85.3%) of under-fives received two recommended rotavirus vaccine (high uptake). Under-fives aged between 13 -18 months were 11.32 times more likely to receive high uptake of rotavirus vaccine than other age groups. Availability of rotavirus vaccine at health facilities (p = 0.035) contributed to its adoption and acceptability. In conclusion, availability of rotavirus vaccine at health facilities had an impact on its uptake and adoption.