A Clinician’s Handbook for Childhood & Adult Immunizations in Georgia

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