The rotavirus vaccine is recommended for infants to protect against gastroenteritis caused by rotavirus disease.
For more information, see Rotavirus Advisory Committee on Immunization Practices Vaccine Recommendations and Centers for Disease Control and Prevention (CDC): Rotavirus Vaccination.
(See also Overview of Immunization.)
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) after a previous dose of the vaccine or to a vaccine component (including latex, which is in the RV1 applicator)
Infants with severe combined immunodeficiency
Infants who have had intussusception
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 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.
More Information
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