Overview
- Live attenuated viral vaccines administered orally.
- Prevents severe dehydrating diarrhea caused by rotavirus.
- Induces mucosal and systemic immunity against the virus.
Vaccine Preparations
| Feature | Rotarix | RotaTeq | Rotavac | Rotasiil |
|---|
| Composition | Human monovalent | Human-bovine pentavalent | Human-bovine monovalent | Bovine pentavalent |
| Strains | G1P8 | G1, G2, G3, G4, P1A | 116E (G9P11) | G1, G2, G3, G4, G9 |
| Dose volume | 1 ml liquid or lyophilized | 2 ml liquid | 5 drops or 0.5 ml liquid | 2 ml or 2.5 ml liquid |
| Total doses | Two doses | Three doses | Three doses | Three doses |
Immunization Schedule
Primary Immunization
- Administered at 6, 10, and 14 weeks of life.
- Minimum age for the first dose remains 6 weeks.
- Rotarix requires only two doses at 6 and 10 weeks.
Maximum Age Limits
- Ideal maximum age for initiating the first dose is 14 weeks and 6 days.
- Vaccination should not be initiated ideally for infants aged 15 weeks or older.
- All doses must be completed by 32 weeks or 8 months of age.
- Strict upper age limit maintained to prevent risk of intussusception.
Catch-Up Immunization
- Universal immunization program permits first dose up to 1 year of age.
- Subsequent doses require a minimum 4-week interval between administrations.
Administration Guidelines
- Route remains strictly oral.
- Given simultaneously with routine childhood vaccines.
- No restriction on feeding or breast milk before or after vaccination.
- Readministration not required if infant spits or regurgitates the vaccine.
- Interchange between vaccine brands should be avoided.
- Storage recommended at 2 to 8 degrees Celsius, without freezing.
Efficacy And Effectiveness
- Efficacy against severe rotavirus gastroenteritis in India ranges from 40% to 60%.
- Reduced efficacy in developing countries attributed to enteropathogen competition and maternal antibodies.
- High absolute reduction in severe disease and mortality due to high baseline disease burden.
Adverse Effects And Contraindications
Adverse Events
- Minor reactions include fever, irritability, and mild self-limiting diarrhea.
- Rare risk of acute intussusception occurs at a rate of 1 to 2 per 100,000 vaccinated infants.
Absolute Contraindications
- Previous history of intussusception.
- Severe combined immunodeficiency.
- Severe allergic reaction to a previous dose.
Precautions
- Defer vaccination during moderate or severe acute gastroenteritis.
- Exercise caution in infants with preexisting chronic intestinal tract disease.
