The rotavirus vaccine is recommended for infants to protect against gastroenteritis Viral gastroenteritis Gastroenteritis is inflammation of the lining of the stomach and small and large intestines. Most cases are infectious, although gastroenteritis may occur after ingestion of drugs, medications... read more caused by rotavirus disease.
(See also Overview of Immunization Overview of Immunization Immunity can be achieved Actively by using antigens (eg, vaccines, toxoids) Passively by using antibodies (eg, immune globulins, antitoxins) A toxoid is a bacterial toxin that has been modified... read more .)
Preparations of Rotavirus Vaccine
Rotavirus vaccines are live-virus vaccines. RV5 and RV1 are currently licensed for use in infants in the United States.
Indications for Rotavirus Vaccine
The rotavirus vaccine is a routine childhood vaccination (see CDC: Child and Adolescent Immunization Schedule by Age).
Contraindications and Precautions for Rotavirus Vaccine
Contraindications for rotavirus vaccines are
A severe allergic reaction (eg, anaphylaxis Anaphylaxis Anaphylaxis is an acute, potentially life-threatening, IgE-mediated allergic reaction that occurs in previously sensitized people when they are reexposed to the sensitizing antigen. Symptoms... read more ) after a previous dose of the vaccine or to a vaccine component (including latex, which is in the RV1 applicator)
The main precautions with rotavirus vaccines are
Moderate or severe illness, including moderate or severe diarrhea or vomiting (vaccination is postponed until the illness resolves; infants with mild illness can be given the vaccine)
The safety and efficacy of rotavirus vaccines have not be established in infants with the following:
HIV/AIDS Human Immunodeficiency Virus (HIV) Infection Human immunodeficiency virus (HIV) infection results from 1 of 2 similar retroviruses (HIV-1 and HIV-2) that destroy CD4+ lymphocytes and impair cell-mediated immunity, increasing risk of certain... read more or any other disease that affects the immune system
Treatment with corticosteroids or other immunosuppressants
Cancer or cancer treatment with radiation or drugs
Dose and Administration of Rotavirus Vaccine
Rotavirus vaccines are given orally by putting drops in the infant's mouth. The dosing for the 2 vaccines is slightly different:
RV5 is given orally in 3 doses, one dose at age 2 months, 4 months, and 6 months.
RV1 is given orally in 2 doses, one dose at age 2 months and 4 months.
If any dose in the series is either RV5 or unknown, default to a 3-dose series.
If the first dose of rotavirus vaccine is inadvertently given at age ≥ 15 weeks, the remaining doses should be given at the routinely recommended intervals.
Rotavirus vaccine should not be given after age 8 months 0 days, even if the series is incomplete.
Adverse Effects of Rotavirus Vaccine
Adverse effects are rare. Infants may become irritable or have mild temporary diarrhea or vomiting.
There is a very small risk of bowel intussusception with the rotavirus vaccine. Intussusception usually occurs within a week after the first or second dose. Surgery may be required.
The following English-language resources may be useful. Please note that THE MANUAL is not responsible for the content of these resources.
Advisory Committee on Immunization Practices (ACIP): Rotavirus ACIP Vaccine Recommendations
Centers for Disease Control and Prevention (CDC): Rotavirus Vaccination: Information for Health Care Professionals
European Centre for Disease Prevention and Control (ECDC): Rotavirus Infection: Recommended vaccinations
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