Vaccination

Rotavirus

Rotavirus transmission is fecal-oral, both through close person-to-person contact and by fomites (e.g. toys, contaminated surfaces); air-borne transmission is questionable. The virus is ubiquitous, found worldwide, and highly communicable with nearly universal infection of children by their 5th birthday. Re-infection of older children and adults is common. The risk for travellers is low since most of them will have immunity acquired through repeated exposures early in life, mainly with sub-clinical infections.

Vaccination is not recommended for adults, children and infants over eight months old.  Routine vaccination of all infants without contraindications is recommended, with three doses of oral vaccine administered at 2-4-6 months of age. The minimum age for the first dose is 6 weeks, and the maximum age for any dose is 32 weeks; the vaccine should not be applied on or after 32 weeks.

Rotavirus vaccine can be administered at the same time as other childhood routine vaccines, such as DTP/Hib/IPV, Hepatitis B and MenC. The main adverse reactions to rotavirus vaccine are: fever, diarrhoea, vomiting and nasopharyngitis. The only contraindication is severe allergic reaction (anaphylactic reaction) to a vaccine component or following a previous dose. In certain pathological situations, such as (1) altered immunocompetence, (2) acute or severe gastroenteritis, or any acute illness, (3) pre-existing chronic gastrointestinal disease, and (4) infants with history of intussusception, the decision to vaccinate should be made based on the risk-benefit analysis.

Fernando Costa Silva, 2007 (last update: 2009)