Rotavirus Oral Vaccine

Why a vaccine is needed for Rotavirus?

Rotavirus infection is the leading cause of severe  diarrhea in children aged <5 years. 

A survey in 2013, estimated 47,100 deaths and  872,000 hospitalizations due to rotavirus in children <5 years of age. Four countries (India, Nigeria, Pakistan and the Democratic Republic of the Congo) accounted approximately half (49%) of all these deaths. 

Most cases of rotavirus diarrhea were found to occur in the first 2 years of life. Most of the rotavirus cases occur in the cooler months of September to February.

The disease spreads mostly through person-to-person. Transmission is by fecal-oral spread, close person-to-person contact  and by fomites(i.e. clothes, beddings, etc). Rotaviruses may also spread by air through respiratory droplets.

Schedule & Administration

This is a Oral Vaccine, i.e. it is given by mouth.

Three doses at least 4 weeks apart starting at age of 6 weeks  along with the other vaccines (DPT, PCV etc). In case RV1 vaccine(ROTARIX) is used then 2 doses are given.

There are no restrictions on the infant’s consumption of food or liquid, including breast milk, either before or after vaccination. Vaccines may be administered during minor illnesses. 

Re-administration need not be done to an infant who regurgitates, spits out, or vomits during or after administration of vaccine.

Type of Vaccine

3 types under  5 different Brand names of vaccines are available in India. – Rotarix, Rotateq, Rotasure, Rotavac, & Rotasiil. All have found to be effective. 

Ideally, the rotavirus vaccine series should be completed with the same product. However, vaccination should not be deferred because the product used for previous doses is not known or unavailable. In such cases, the series should be continued with the product that is available. 

Upper age limit for starting First Dose of Rotavirus oral vaccine

Indian Academy of Pediatrics  recommends that Immunization should not be initiated in infants 15 weeks or older because of insufficient safety data for vaccines use in older children. All the doses of either of the vaccines should be completed within 8 months (32 weeks) of age. 

Although, the available new generations of rotavirus vaccines are considered quite safe and the risk of acute intussusception is very small in comparison to previous vaccine, so to widen the coverage & decrease the disease burden, UIP recommends an upper age limit of 1 year while WHO mentions upper age as 2 yrs for initiation of vaccination.