As far as Hib and other conjugate polysaccharide vaccines are concerned,
the dose schedule depends on the maturity of the immune system with
increasing age and not sub-clinical infection leading to some immunity, as
is thought of. That is why one needs lesser number of doses as age
advances. This is also proved by the fact that children with baseline
antibodies are not protected against disease unless the levels are more
than protective levels (which we typically achieved very early in life
with conjugate vaccines).
For rotavirus infection, first natural infection is the
most severe and often leads to hospitalization. However, it also then
protects against severe disease with subsequent exposure to any other
rotavirus. Whereas the rotavirus vaccine mimicks this natural process, but
without the vaccine suffering from any rotavirus vaccine virus. Hence to
say that only one dose should be enough at 4-6 months is not correct as (i)
that particular child may not have been exposed to any rotavirus by that
age as is evident by the epidemiology in India; (ii) there is no
mild first disease leading to sub-clinical immunity; and (iii)
waiting for 4-6 months may lead to first natural infection in that child
before the vaccine is given and may lead to severe disease. The second
dose is given to ensure seroconversion/protection in those who may not
have seroconverted/protected with the first dose.
As far as varicella is concerned, sub-clinical
infection is extremely rare and most of the first exposures lead to
clinical varicella (severity of which increases with the age). Varicella
behaves differently in tropical climate, like ours where up to 39% of
children do not get exposure to varicella even till adolescence (hence not
getting any "chance" to develop any "sub-clinical" case). From studies
done on vaccinees, we very well know that for children >12 years
seroconversion with one dose of vaccine is only 79% and that it reached
98% only with 2 doses. Now we also know that even for children <12 year we
need 2 doses of varicella vaccine to ensure maximum protection against
clinical varicella, especially break-through varicella. Hence we do need 2
doses of varicella vaccine at any given age.