WHO recommendations for the inclusion of several new vaccines in national immunization programs (NIPs) will require surveillance of additional vaccine preventable diseases (VPDs). To inform vaccine introduction decisions, many global and regional initiatives, including the Asian Rotavirus Surveillance Network (ARSN), have generated disease burden data from multiple countries on these new VPDs. Sentinel hospital-based surveillance, which is both under the overall management of national surveillance agency and as part of a regional network, may be the most practical model for long-term surveillance for common VPDs with a non-specific clinical picture. However integration of these new surveillance strategies with existing VPDs surveillance may face several political, programmatic and technical challenges.