II. Indications
- Primary Series in the first year of life in the United States
III. Pharmacokinetics
- Oral Tetravalent live virus Vaccine
IV. Preparations
- Rotarix (RV1)
- Monovalent two dose series
- RotaTeq (RV5)
- Pentavalent three dose series
V. Dosing
- Schedule (4 week minimum interval between doses)
- Dose 1: Age 2 months
- First dose must be between ages 6-15 weeks - previously 12 weeks
- Avoid starting series after 15 weeks of age
- Dose 2: Age 4 months
- Dose 3: Age 6 months
- Third dose must be given by 8 months of age
- Third dose is required if RotaTeq was used for any dose, or unknown
- Third dose is not needed if Rotarix (RV1) was given for first two doses
- Dose 1: Age 2 months
- Dose
- Give full vial for each dose (no need to repeat if infant spits up part of dose)
VI. Contraindications
- Immunocompromised infants
- Severe concurrent illness including Gastroenteritis
- History of Intussusception
- Allergy to Vaccine components
VII. Adverse Effects
- Fever after first dose within 3 days
- Adverse effects increase after age 12 months
- Possible association with Kawasaki's Disease
- Increased Incidence of Intussusception
- Most significant with RotaShield Vaccine (Removed from the U.S. market)
- Rotarix and RotaTeq are safer
- Intussusception risk is now minimal (0.79 in 100,000 cases)
- Intussusception typically occurs days 3 to 6 after first Rotavirus Vaccine dose
- References
VIII. Efficacy
- Prevents 50-70% of all Rotavirus cases
- Prevents 70-90% of severe Rotavirus cases
- Seropositive response: 92%
- For every 4 million children immunized against Rotavirus
- Physician visits decrease by 255,000
- Emergency Department visits decrease by 137,000
- Hospitalizations decreased by 44,000
- Deaths decrease by 13
- Cortese (2009) MMWR Recomm Rep 58(RR-2):1-25 [PubMed]
IX. Resources
- CDC Immunization Schedules (last accessed 10/28/2020)