Rotavirus Vaccine: What to Know

Rotavirus disease is caused by a highly contagious virus that causes severe watery diarrhea, severe vomiting, abdominal pain, and fever in infants and young children. Rotavirus vaccines are available to protect against this potentially life-threatening infection. The CDC recommends all infants get this vaccine. Please continue reading to find out more about the rotavirus vaccine.

How serious is a rotavirus infection?

Rotavirus disease can be serious in infants and young children. Severe rotavirus disease can lead to dehydration, requiring hospitalization. Healthy adults who get infected with rotavirus usually develop mild symptoms or none at all. 

What are the different types of rotavirus vaccines?

There are two rotavirus vaccines available in the United States:

• Rotarix® (RV1): This rotavirus vaccine is given in two doses when the baby is 2 months and 4 months of age.
• RotaTeq® (RV5): This rotavirus vaccine is given in three doses when the baby is 2 months, 4 months, and 6 months of age. RotaTeq is the first rotavirus vaccine.

Both the current rotavirus vaccines are oral vaccines that are given by putting drops in the child’s mouth.

Who should get rotavirus vaccination?

The CDC recommends that all infants get the recommended 2 or 3 doses of rotavirus vaccine (depending on the brand). This is one of the routine childhood vaccines. Infants who have received all the recommended doses of the vaccine will generally be protected from rotavirus infection. Large clinical trials have proven the safety and efficacy of both Rotarix and RotaTeq.  

The rotavirus vaccination is routinely recommended to begin in infants between 6 and 12 weeks of age (a month and a half to 3 months of age). As mentioned, this vaccine is given as a 2 or 3-dose series, depending on the brand. 

Below is the recommendation for the rotavirus vaccine schedule:

• First dose: 2 months of age
• Second dose: 4 months of age
• Third dose (if using RotaTeq): 6 months of age

The minimum interval between the first and second dose is 4 weeks. 

Keep in mind that there is an age limit for rotavirus vaccine; all doses of the vaccine should be given before 32 weeks of age (8 months old). 

Who should not get the rotavirus vaccine?

The rotavirus vaccine is not suitable for older children. Generally, the first dose cannot be administered later than 15 weeks, and the second dose must not be later than 24 weeks. This vaccine has an age limit of 32 weeks of age. Thus, it should not be given in the following scenario:

• Rotavirus should not be given to babies who are older than 15 weeks of age and have not received the first dose of the series;
• Babies who had a first dose but are older than 24 weeks; the second dose cannot be given after 24 weeks old (6 months of age).  

In general, most children who have minor illnesses can receive vaccines. Children who are moderately to severely ill should wait until they are better before undergoing vaccinations. 

The rotavirus vaccine should not be given to infants with the following:

• Severe allergic reaction after a previous dose of the rotavirus vaccine.
• Severe allergy or adverse reactions to any of the components in the two rotavirus vaccines (RotaTeq or Rotarix vaccines), including a severe latex (rubber) allergy.
• Severe combined immunodeficiency (SCID), a condition in which the baby’s immune system cannot fight infections.
• Previous bowel blockage (called intussusception) or increased risk of intussusception. 

You should talk to a doctor before vaccinating your child if they have one or more of the following conditions:

• Weakened immune system due to HIV/AIDS or other conditions that affect the baby’s immune system. 
• Babies taking steroid medications, cancer drugs, or immune system treatment.

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What to expect after my baby gets the rotavirus vaccine?

Most babies do not have any side effects after getting the rotavirus vaccine. However, some babies may have mild side effects such as irritability, temporary diarrhea, and vomiting. 

Serious side effects are rare but include intussusception (bowel blockage) that needs to be treated in a hospital and may require surgery in some cases. There is a very small risk of this complication, but when intussusception develops after rotavirus vaccination, it is usually within a week of receiving a dose of rotavirus vaccine. 

There is a very remote chance of the rotavirus vaccine causing a severe allergic reaction. A serious reaction usually occurs shortly after the vaccination (within a few minutes to hours). In these cases, the subsequent dose of the rotavirus vaccine is not recommended if your child has had a severe allergic reaction to an earlier dose. Just like any medicine, the risk of serious injury or death due to vaccination is very small. 

How effective is the rotavirus vaccine?

The Centers for Disease Control and Prevention (CDC) says 70-80% of children are completely protected from rotavirus infection after getting the rotavirus vaccine. Additionally, 90% of children are protected from severe diarrhea and other symptoms of rotavirus disease. 

Can I catch rotavirus from my baby's vaccine?

You may catch rotavirus from your baby’s vaccine because it is an oral vaccine. The rotavirus vaccine contains a weakened form of the virus. It is given as oral drops into the baby’s mouth and passes through the baby's gut. Therefore, when you change your baby’s diaper, you can potentially contract rotavirus. However, these traces of the weakened virus are unlikely to cause rotavirus disease in healthy adults. You can lower your risk of contracting rotavirus by washing your hands thoroughly with soap and water after changing diapers.

Can I breastfeed my baby after the rotavirus vaccination?

Yes, there is no restriction on breastfeeding a baby who recently got the rotavirus vaccine.

Can I kiss my baby after the rotavirus vaccine?

Studies have not been done to investigate if the weakened virus in a rotavirus vaccine can be transferred from kissing a baby on the mouth after rotavirus vaccination. While it is unlikely to cause rotavirus spread or illness in healthy adults via this route, it is theoretically possible. 

What precautions should be taken after the rotavirus vaccine?

You should take special care to wash your hands carefully after changing your baby’s diaper for at least 2 weeks after they get the vaccine. While the weak rotavirus in the oral vaccine is unlikely to cause rotavirus infection in healthy adults, it may be a risk if you have a compromised immune system. 

Can my baby get the rotavirus vaccine with other vaccines?

Yes, vaccines such as polio, DTaP, Hib, pneumococcal conjugate, and hepatitis B can safely be given to your child at the same doctor’s visit as the first or second dose of the rotavirus vaccine. Rotavirus vaccine does not affect the immune response of these vaccines.