Pathophysiology
- Virus
- Transmitted by fecal-oral route. However, transmission by fomites and respiratory route may also occur.
- Incubation 2-4 days
Vaccine Description
RotaTeq® (RV5) – Live, oral pentavalent vaccine
Rotarix® (RV1) – Live, Oral Vaccine
Dose & Route
- RotaTeq® (RV5) – Three (3) 2-ml oral doses
- Rotarix® (RV1) – Two (2) 1-ml oral doses
Administration Schedule & Minimum Intervals
Note: If an incomplete dose is administered (i.e., infant spits or regurgitates vaccine), a replacement dose is not needed. Continue the series using the recommended intervals. Do not administer after 32 weeks of age.
Infants who have had rotavirus gastroenteritis before receiving the full course of rotavirus vaccinations should still initiate or complete the 3-dose schedule because the initial infection frequently provides only partial immunity.
Recommended Schedule for Rotavirus Vaccines
Rotavirus vaccines are not to be started after 14 weeks, 6 days, and all doses are to be completed by 8 months.
RotaTeq® & Rotarix®
Dose Age
Primary 1……..2 months
Primary 2……..4 months
Primary 3……..6 months
Interchangeability of Rotavirus Vaccines
ACIP recommends that the rotavirus vaccine series be completed with the same product whenever possible. However, vaccination should not be deferred if the product used for previous doses is not available or is unknown. In this situation, the provider should continue or complete the series with the product available. If any dose in the series was RotaTeq® or the manufacturer is unknown for any doses in the series, a total of three doses of rotavirus vaccine should be given.
Contraindications
Demonstrated hypersensitivity to the vaccine or any component of the vaccine
Precautions
Note: The oral applicator of Rotarix® contains latex. Use precaution with infants with a previous hypersensitivity to latex.
- Acute gastroenteritis
- Moderate to severe illness
- Preexisting chronic gastrointestinal disease
- History of intussusception
- Altered immunocompetence due to:
- Blood dyscrasias
- Immunosuppressive therapy
- Primary and acquired immunodeficiency such as HIV
Special Considerations
- Shedding of virus in the stool after vaccine administration is possible. Caution is advised when considering administration of vaccine to persons with immunocompromised household contacts.
- Can be administered on same visit with other routinely recommended vaccines
- No restrictions on infant’s consumption of food or liquid, including breast milk, before or after receiving vaccine
- If an incomplete dose is administered (i.e., infant spits or regurgitates vaccine), a replacement dose is not recommended. Continue the series using intervals as outlined above.
- Rotavirus may be administered at any time before, concurrent with, or after administration of any blood product including antibody containing product.
- The new Rotarix® vaccine is an all-liquid formulation and does not need to be reconstituted