Significance:
We identified dynamic changes in rotavirus molecular epidemiology in a prospective cohort of children with acute gastroenteritis during pre- and post- monovalent rotavirus vaccine (RV1) introduction era. While the circulating rotavirus genotypes remained mostly unchanged, strain predominance varied yearly. We found the emergent G12P[8] strain predominantly infected older children and was the most common strain in fully vaccinated children. Knowledge of the association between rotavirus genotype diversity and AGE clinical severity is limited. Our data suggest that other than RV1 related G1P[8] isolates, the clinical severity of different rotavirus genotypes did not differ significantly, thus emphasizing the need for rotavirus vaccines that protects against all genotypes.