Rotavirus Vaccine Overview

Rotavirus is transmitted through stool. It is easily spread by contaminated hands and objects. Symptoms usually begin about two days after exposure and may include:

• Fever
• Upset stomach
• Vomiting (can last 3-8 days)
• Diarrhea (can last 3-8 days)—the leading cause of diarrhea in infants and children in the US
• Loss of interest in eating and drinking
• Dehydration

Treatment involves replacing lost body fluids by drinking fluids. Severe cases may require fluids given through an IV line (a needle is inserted into a vein).

According to the US Centers for Disease Control and Prevention (CDC), almost all children are likely to become infected with rotavirus before age five. Now that the vaccine is routinely given, the number of cases has significantly dropped. In addition, while rotavirus is most common in the winter and spring, the season for this virus has been delayed and shortened because of the vaccine.

The rotavirus vaccine, called RotaTeq, is a live virus vaccine. This means it contains a living virus that is able to produce immunity to the disease. The vaccine is given by mouth.

Another vaccine, called Rotarix, is for preventing rotavirus gastroenteritis in infants.

Depending on which type of vaccine your baby gets, he will need two or three doses. The recommended schedule for giving these doses is:

• 2 months for first dose
• 4 months for second dose
• 6 months for third dose (if using RotaTeq vaccine)

Most infants tolerate the vaccines with no problem. In a small number of cases, children may have mild diarrhea or vomiting after RotaTeq.

As with any vaccine, there is a small risk of severe reaction, such as a severe allergic reaction.

The vaccines that are used today are different from the one used in the 1990s. The older vaccine was associated with unacceptably high rates of a serious bowel obstruction called intussusception . The newer RotaTeq is associated with lower rates of this condition. But, there is a small risk of intussusception with Rotarix.

Children should not get the vaccine if they:

• Have had a life-threatening allergic reaction from a previous dose or any of its components
• Are moderately or severely ill (They can get the vaccine after recovering.)
• Have had a blood transfusion
• Have a weakened immune systems (eg, those with HIV infection or AIDS )
• Are taking long-term steroid medicines
• Have cancer
• Have had intussusception or have an abnormality of the intestine (increasing the risk of intussusception)

It is important that you wash your hands and practice good hygiene. However, these steps have not been shown to significantly prevent rotavirus.

In the event of an outbreak, authorities will test food and water sources to make sure they are not contaminated. To help the virus from spreading, frequent hand washing and washing of surfaces is recommended. Soiled linens and clothes should be handled as little as possible. These items should be laundered with detergent and machine-dried.

WHERE CAN I GET MORE INFORMATION?

National Network for Immunization Information
http://www.immunizationinfo.org/vaccineInfo/index.cfm

National Immunization Program
Centers for Disease Control and Prevention
http://www.cdc.gov/vaccines/

References:

Centers for Disease Control and Prevention. Rotavirus vaccine. Centers for Disease and Control and Prevnetion website. Available at: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-rotavirus.pdf . Update May 14, 2010. Accessed June 11, 2010.

Ciarlet M, Schodel F. Development of a rotavirus vaccine: clinical safety, immunogenicity, and efficacy of the pentavalent rotavirus vaccine, RotaTeq. Vaccine.2009;27(Suppl 6):G72-81.

Desai SN, Esposito DB, Shapiro ED, Dennehy PH, Vázquez M. Effectiveness of rotavirus vaccine in preventing hospitalization due to rotavirus gastroenteritis in young children in Connecticut, USA. Vaccine.2010 Sep 16.

GlaxoSmithKline. Highlights of prescribing information. The Carter Foundation website. Available at: http://us.gsk.com/products/assets/us_rotarix.pdf . Accessed December 12, 2008.

Merck & Co, Inc. Highlights of prescribing information. Merck website.Available at: http://www.merck.com/product/usa/picirculars/r/rotateq/rotateqpi.pdf . Accessed December 12, 2008.

O'Ryan M, Linhares AC. Update on Rotarix: an oral human rotavirus vaccine. Expert Rev Vaccines.2009;8(12):1627-1641.

Rotavirus vaccination. US Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/vpd-vac/rotavirus/default.htm . Accessed January 31, 2007.

Vaccines. US Food and Drug Administration website. Available at: http://www.fda.gov/cber/vaccines.htm . Accessed January 31, 2007.

1/31/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0-18 years—United States, 2008. MMWR.2008;57;Q1-Q4. Centers for Disease Control and Prevention, MMWR website. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5701a8.htm . Updated January 10, 2008. Accessed January 28, 2008.

4/14/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Haber P, Patel M, Izurieta HS, et al. Postlicensure monitoring of intussusception after RotaTeq vaccination in the United States, February 1, 2006, to September 25, 2007. Pediatrics. 2008;121:1206-1212.

10/30/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Centers for Disease Control and Prevention. Reduction in rotavirus after vaccine introduction—United States, 2000-2009. MMWR Morb Mortal Wkly Rep. 2009;58(41):1146-1149.