What rotavirus vaccine (Rotarix or RotaTeq) does the UK National Health Service (NHS) recommend for a healthy 8-week-old infant?

UK NHS Rotavirus Vaccine Recommendation for 8-Week-Old Infants

The UK NHS uses Rotarix (a 2-dose oral rotavirus vaccine) administered at 8 weeks and 12 weeks of age for routine infant immunization. 1

Vaccine Selection and Schedule

• Rotarix was specifically selected by the UK NHS following a tender process and introduced into the UK childhood immunisation programme in 2013. 1

• The vaccine is administered as two oral doses: the first at 8 weeks (2 months) and the second at 12 weeks (3 months) of age. 1, 2

• This differs from the US ACIP recommendations, which offer a choice between Rotarix (2-dose) or RotaTeq (3-dose), whereas the UK has standardized on Rotarix exclusively. 3, 1

Critical Timing Requirements

• The first dose must be given between 6 and 14 weeks of age, with the last dose completed by 24 weeks of age in the UK program. 1

• At 8 weeks of age, this infant is within the optimal window for the first dose of Rotarix. 1, 2

• The minimum interval between doses is 4 weeks, making the 8-week and 12-week schedule appropriate. 3, 4

UK Program Performance

• Vaccine uptake in the UK has been excellent, with 90-92% of infants receiving the recommended 2 doses of Rotarix between February 2014 and March 2015. 2

• The program has demonstrated an 82% average reduction in laboratory-confirmed rotavirus cases in post-vaccination seasons, with an 89% reduction in infants under 1 year. 2

• Indirect (herd) protection has been observed, with a 75-77% reduction in cases among unvaccinated children aged 1 to <5 years. 2

Safety Profile

• When administered within the recommended age window (first dose between 6-14 weeks), Rotarix carries only a small risk of intussusception within the week of vaccination, resulting in negligible population attributable risk. 1

• The vaccine has been generally well tolerated in healthy infants and did not appear to be associated with increased intussusception risk in pre-licensure trials. 5

Administration Details

• Each dose consists of 1.5 mL of oral liquid administered directly into the infant's mouth. 4

• Rotarix may be given concurrently with other routine infant vaccines including DTaP, Hib, IPV, hepatitis B, and pneumococcal conjugate vaccine. 4, 5

Common Pitfall to Avoid

• Do not delay the first dose beyond 14 weeks and 6 days of age, as the infant becomes permanently ineligible for rotavirus vaccination after this point due to safety concerns. 4, 6