From the Guidelines
The rotavirus vaccine is recommended as a 2 or 3-dose series for infants, depending on the brand used, with efficacy increasing to about 85-98% against severe disease after completing the full series, as demonstrated in studies such as 1. The vaccine schedule for rotavirus vaccine is as follows:
- For Rotarix (RV1), two doses are given at 2 and 4 months of age
- For RotaTeq (RV5), three doses are given at 2,4, and 6 months of age The first dose should be administered between 6 weeks and 14 weeks 6 days of age, with the final dose completed by 8 months 0 days, as recommended by the American Academy of Pediatrics 1. Efficacy increases with each dose administered, with protection against severe rotavirus gastroenteritis estimated to be approximately 50-60% after the first dose, and 74-87% against any rotavirus disease after completing the full series, as shown in studies such as 1. The vaccine works by introducing attenuated (weakened) rotavirus strains that stimulate the immune system to develop antibodies without causing disease, providing protection when the child is later exposed to wild-type rotavirus, which is the leading cause of severe diarrhea and dehydration in infants worldwide. Key points to consider when administering the rotavirus vaccine include:
- The minimum interval between doses is 4 weeks
- The maximum age for the last dose is 8 months 0 days
- The vaccine is particularly important because it prevents the most severe cases that might require hospitalization, though mild breakthrough infections can still occur, as noted in studies such as 1.
From the Research
Rotavirus Vaccine Schedule
- The recommended Rotavirus vaccine schedule is as follows:
- Three doses of RotaTeq are recommended at ages 2,4, and 6 months 2
- The first dose should be administered between ages 6 and 12 weeks, and vaccination should not be initiated for infants aged >12 weeks 2
- Subsequent doses should be administered at 4-10 week intervals, with all doses administered by age 32 weeks 2
- Alternatively, a 2-dose monovalent vaccine, Rotarix, can be administered at ages 2 and 4 months 3, 4
Efficacy of Rotavirus Vaccine
- The efficacy of the Rotavirus vaccine has been demonstrated in several studies:
- A study found that the RRV-TV vaccine prevented 49% of rotavirus episodes, 80% of very severe episodes, and 100% of dehydrating rotavirus illness 5
- Another study found that the RotaTeq vaccine was highly effective in preventing severe rotavirus illness, with a significant reduction in the incidence of rotavirus gastroenteritis 2
- The vaccine has also been shown to be effective in reducing the incidence of gastroenteritis of all causes and dehydrating diarrhea 5
Adherence to Vaccination Schedule
- Adherence to the recommended vaccination schedule is important for optimal protection against Rotavirus:
- A study found that 84.3% of infants completed a full series of Rotavirus vaccine, with a greater proportion of infants completing the series with the RV1 vaccine compared to the RV5 vaccine 3
- Another study found that RV coverage increased following vaccine introduction, but was lower than coverage with other routinely-recommended vaccines 4