Yes, Continue the Rotavirus Vaccine Series
Infants who develop rotavirus gastroenteritis after receiving an initial dose of rotavirus vaccine should still complete the remaining doses of the vaccine series according to the recommended schedule, because natural rotavirus infection provides only partial immunity against future rotavirus disease. 1
Rationale for Continuing Vaccination
The Advisory Committee on Immunization Practices (ACIP) explicitly addresses this scenario in their guidelines:
Natural infection offers incomplete protection: A single rotavirus infection—whether from wild-type virus or breakthrough infection after vaccination—frequently provides only partial immunity against subsequent rotavirus disease 1
Complete vaccine series maximizes protection: The full vaccine series (either 2 or 3 doses depending on the product) is designed to provide comprehensive protection against multiple rotavirus serotypes and severe disease 1
No safety concerns with continuing: There is no evidence that completing the vaccination series after natural infection increases adverse events or poses additional risks 1
Practical Implementation
Timing Considerations
Maintain the standard schedule: Continue with the next scheduled dose according to age-appropriate timing (minimum 4-week interval between doses) 1
Complete by age deadline: All doses must be administered by 8 months and 0 days of age for both RV5 (RotaTeq) and RV1 (Rotarix) 1
Do not delay: The occurrence of rotavirus infection should not delay the next scheduled vaccine dose once the infant has recovered from the acute illness 1
Clinical Approach
Wait for acute illness resolution: Like other vaccines, rotavirus vaccine can be administered to infants with minor acute illnesses, but practitioners should wait until moderate-to-severe gastroenteritis has resolved 1
No serologic testing needed: Do not check antibody titers or attempt to confirm the infection was rotavirus before proceeding with vaccination—simply continue the series 1
Important Caveats
The recommendation to continue vaccination applies only if the infant is still within the age window for rotavirus vaccination. The first dose must be initiated by 14 weeks and 6 days of age, and all doses must be completed by 8 months and 0 days 1, 2. If the infant has aged out of eligibility, vaccination cannot be initiated or continued.
This guidance reflects the understanding that vaccine-induced immunity is more comprehensive and durable than natural infection alone, particularly for preventing severe rotavirus gastroenteritis requiring hospitalization 1.