Prior to the introduction of rotavirus vaccines in 2006, rotavirus was the leading cause of severe gastroenteritis among US children <5 years of age. In the first 7 years of vaccine use, both recommended rotavirus vaccines (RotaTeq [RV5] and Rotarix [RV1]) have been shown to be highly effective in preventing outcomes of severe disease in US children in a variety of settings. In addition, substantial decreases in severe diarrheal disease in US children, exceeding the level expected based on vaccine coverage, as well as the extension of benefits to older age groups ineligible for vaccination have demonstrated both the direct and indirect impacts of vaccination in the USA.