The risk of intussuception is about 1 to 2 cases for every , babies that get the vaccine. At most, this could affect 1 baby a year in B. By comparison, each year in B. Signs of intussusception may include a swollen abdomen, frequent vomiting, and bloody stools. Your baby could seem weak and irritable and have several bouts of intense crying. If your baby shows these signs, you should take your baby to the nearest emergency department. It is important to stay in the clinic for 15 minutes after getting any vaccine because there is an extremely rare possibility, less than 1 in a million, of a life-threatening allergic reaction called anaphylaxis.
This may include hives, difficulty breathing, or swelling of the throat, tongue or lips. Should this reaction occur your health care provider is prepared to treat it. Emergency treatment includes the administration of epinephrine adrenaline and transfer by ambulance to the the nearest emergency department. If symptoms develop after you leave the clinic, call or the local emergency number.
Babies who have moderate or severe diarrhea or vomiting, or a serious illness should not be immunized until they have recovered from their illness. There is no need to delay getting immunized because of a cold or other mild illness. However, if you have concerns, speak with your health care provider.
Rotavirus is a virus that causes gastroenteritis, sometimes called the stomach flu. Rotavirus is the most common cause of diarrhea and hospitalization for diarrhea in children under 5 years of age. Almost all children will have at least 1 rotavirus infection before they are 5 years of age. The first symptoms of rotavirus infection are often fever and vomiting, followed by diarrhea and stomach pain. These symptoms appear 1 to 3 days after a person has been infected with the virus.
Diarrhea can last from 4 to 8 days. Don't put the dropper so far back that you gag the child. You may find the following information from the RotaTeq manufacturer helpful: www.
You can also find a pictorial description of both reconstitution and administration of Rotarix at www. Can rotavirus vaccine be given via G-Tube? If so, is it okay to flush with normal saline or sterile water? The manufacturer has not addressed this issue but CDC considers administration of rotavirus vaccine via gastrostomy tube to be acceptable practice.
There should be no problem flushing the tube after vaccine has been administered. Is it okay to administer rotavirus vaccine and immune globulin at the same time? The effectiveness concerns with antibody-containing blood products ACBP do not apply to rotavirus vaccine, since it is administered orally and replication of the vaccine virus occurs in the GI tract, "separate" from the site of the ACBP.
Note that the child should be carefully screened for other potential contraindications or precautions to vaccination since administration of immune globulin could indicate immunosuppression. We received a report of an infant who received rotavirus vaccine intramuscularly rather than orally. Is this dose valid? If not, when should it be repeated? The rotavirus vaccine dose given by the intramuscular route is not valid and should be repeated by the oral route as soon as possible.
In a review of such rotavirus vaccine administration errors, there usually were not adverse reactions, and those documented were limited to local reactions and general, brief irritability. See www. Please take steps to ensure that such vaccine administration errors are avoided in the future.
Rotavirus vaccine virus is shed during the first weeks after administration of rotavirus vaccine. Handwashing after diaper changing is always recommended. Contraindications and Precautions Back to top Which infants should not receive rotavirus vaccine? Do not give rotavirus vaccine to an infant who has a history of a severe allergic reaction for example, anaphylaxis after a previous dose of rotavirus vaccine or to a vaccine component.
The oral applicator for Rotarix contains natural latex rubber so infants with a severe anaphylactic allergy to latex should not be given Rotarix; the RotaTeq Merck dosing tube is latex-free. Rotavirus vaccine is contraindicated in infants with the rare disorder severe combined immunodeficiency SCID and in infants with a history of intussusception. Practitioners should consider the potential risks and benefits of administering rotavirus vaccine to infants with known or suspected altered immunocompetence, including those whose mothers received immunosuppressive biologics such as infliximab during pregnancy.
Consultation with an immunologist or infectious diseases specialist is advised. Children and adults who are immunocompromised because of congenital immunodeficiency, hematopoietic transplantation, or solid organ transplantation sometimes experience severe or prolonged rotavirus gastroenteritis. However, few safety or efficacy data are available for the administration of rotavirus vaccine to infants who are immunocompromised or potentially immunocompromised, including 1 infants with primary and acquired immunodeficiency, cellular immunodeficiency, and hypogammaglobulinemia and dysgammaglobulinemia; 2 infants with blood dyscrasias, leukemia, lymphomas, or other malignant neoplasms affecting the bone marrow or lymphatic system; 3 infants on immunosuppressive therapy including high-dose systemic corticosteroids ; and 4 infants who are HIV-exposed or infected.
A woman in our practice received infliximab Remicade, Janssen Pharmaceuticals for treatment of Crohn's Disease while she was pregnant. Should we modify her infant's vaccination schedule because of this treatment? Infliximab is an IgG monoclonal antibody that neutralizes the biological activity of tumor necrosis factor-alpha.
Like other IgG antibodies infliximab crosses the placenta. Infliximab has been detected in the blood of infants up to 6 months following birth. Consequently, these infants may be at increased risk of serious infection. Neither ACIP nor CDC provides specific guidance on this issue because there are few data on safety or efficacy in children exposed to potentially immunosuppressive biologics during pregnancy. As noted above, practitioners should consider the potential risks and benefits of administering rotavirus vaccine to infants with known or suspected altered immunocompetence.
The manufacturer recommends that live vaccines rotavirus and BCG be deferred for at least six months after birth for infants whose mothers received infliximab during pregnancy. Inactivated vaccines should be given on schedule. Can rotavirus vaccine be given to an infant who has an immunosuppressed household contact?
Having an immunocompromised household contact is not usually a reason for delaying routine vaccination for others in the household. Rotavirus vaccine should be administered to susceptible household contacts and other close contacts of immunocompromised patients when indicated. All members of the household should wash their hands after changing the diaper of an infant. This minimizes rotavirus transmission from an infant who received rotavirus vaccine.
Vaccine Safety Back to top What adverse reactions have been reported following rotavirus vaccines? In the RotaTeq clinical trials in the first week after any dose vaccine recipients had a small but statistically significant increased rate of diarrhea During the day period following any dose, statistically significantly greater rates of diarrhea, vomiting, otitis media, nasopharyngitis and bronchospasm occurred in RotaTeq recipients compared with placebo recipients.
In the Rotarix clinical trials, in the first week after vaccination, Grade 3 i. During the 31 day period after vaccination, these unsolicited adverse events occurred at a statistically higher incidence among vaccine recipients: irritability Have the current rotavirus vaccines been associated with intussusception? Large pre-licensure clinical trials of both RotaTeq and Rotarix did not find an increased risk for intussusception among vaccine recipients.
A large post-licensure study of more than 1. No increased risk of intussusception was found after the second or third doses.
CDC and the Food and Drug Administration FDA continue to believe that the benefits of rotavirus vaccination outweigh the risks associated with vaccination and that routine vaccination of infants should continue. However, the study indicated an increased risk of intussusception following dose 1 and dose 2 of Rotarix. Over , doses of Rotarix have been given to children monitored in VSD. Based on these findings, one case of intussusception would be expected for approximately each 20, children who are fully vaccinated.
Storage and Handling What are the storage and handling guidelines for rotavirus vaccine RotaTeq and Rotarix? Both vaccines should be stored at refrigerator temperature and protected from light. Do not administer the vaccine if it has been frozen or exposed to freezing temperatures. Back to top This page was updated on October 22, This page was reviewed on August 30, Immunization Action Coalition.
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Technically Speaking. Honor Rolls for Patient Safety. Unprotected People Stories. IAC Express. Vaccine Information Statements. View All Materials. The brand name of the vaccine used in the UK is Rotarix. This vaccine has been used in many countries for more than 10 years.
Read the patient information leaflet PIL for Rotarix on the electronic medicines compendium website. Most babies do not have any problems at all after having their rotavirus vaccination. Some babies who have the vaccine may become restless and irritable, and some may develop mild diarrhoea in the days following vaccination. Page last reviewed: 16 April Next review due: 16 April Rotavirus vaccine overview.
Why the rotavirus vaccine is offered Rotavirus is a highly infectious stomach bug that typically affects babies and young children, causing diarrhoea and vomiting , tummy ache and a high temperature. When babies can have the rotavirus vaccination Rotavirus vaccination is available routinely on the NHS as part of the childhood vaccination programme for babies aged 8 weeks and 12 weeks.
How the rotavirus vaccine works The vaccine contains a weakened version of rotavirus. Effectiveness of the rotavirus vaccine The rotavirus vaccine is very effective and gives good protection against rotavirus infection.
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