| Why
is it important to vaccinate against rotavirus? Isn't the disease
benign? |
 |
| Rotavirus is the most common cause of severe gastroenteritis in
infants and young children. The disease may cause severe dehydrating
diarrhea with vomiting and fever. Almost all children are infected
by age 5 years. Annually, rotavirus in the U.S. is responsible for
3 million infections, more than 400,000 physician visits, 160,000 emergency
department visits, 55,000–70,000 hospitalizations, and between 20 and
60 deaths. |
|
| What are the recommendations for use
of
RotaTeq? |
|
| RotaTeq (by Merck) was licensed in
February 2006 and is recommended for routine oral administration for
all infants as a 3-dose series. The usual schedule is at ages 2, 4, and
6 months. The first dose may be given as early as age 6 weeks. The
vaccine should not be administered to infants older than 32 weeks, even
if the 3-dose series has not been completed. The first dose should be
administered between ages 6 and 12 weeks. A minimum interval of 4 weeks
should be observed between each of the doses. |
|
| Where can I find the recommendations
for the use of rotavirus vaccine? |
|
| The ACIP recommendations can be found at
www.cdc.gov/mmwr/PDF/rr/rr5512.pdf. Those of the AAP are at
http://aappolicy.aappublications.org/cgi/content/full/pediatrics;119/1/171 |
|
| Would you please clarify the
definition of the maximum ages for doses of rotavirus vaccine? |
|
| A child is 12 weeks old until his or her
13th-week birthday. A child is 32 weeks old until the 33rd-week
birthday. |
|
| If the first dose of rotavirus
vaccine is inadvertently given to a child older than age 13 weeks,
should the series be continued? |
|
| Infants for whom the first dose of
rotavirus vaccine was inadvertently administered off-label at age 13
weeks or older may receive the remaining 2 doses of the series at the
routinely recommended intervals. Timing of the first dose should not
affect the safety and efficacy of the second and third doses. Rotavirus
vaccine should not be given after age 32 weeks even if the series is
incomplete. |
|
| If a child has received 2 doses of
rotavirus vaccine on schedule but doesn't get dose #3 by age 32 weeks,
should we vaccinate or not? |
|
| An infant should not receive any
rotavirus vaccine once she or he is age 33 weeks. |
|
| Our experience has been that many
babies who receive RotaTeq spit a lot of it out. We know not to give
them more. But how can we be sure that the little they ingest is enough? |
|
| Try to follow general guidelines for
oral administration of liquid vaccines. First, give this vaccine at the
beginning of the office visit, while the baby is still happy, and before
you administer injections or perform other procedures. Second, make
every effort to aim the dropper containing the vaccine down one side and
toward the back of the child's mouth. Don't put the dropper so far back
that you gag the child. You may find the following resource helpful:
www.merckvaccines.com/rotateqProd-uctPage_frmst.html. Click on
"Dosage and Administration," and scroll down for an educational video on
administration. |
|
| What are the storage and handling
guidelines for RotaTeq? |
|
| RotaTeq should be stored at refrigerator
temperature and protected from light.
Do not administer the
vaccine if it has been frozen or exposed to freezing temperatures. |
|
| Which infants should not receive RotaTeq? |
|
| Do not give it to an infant who has a severe allergic reaction to
an RV vaccine component or following a prior dose, has altered immunocompetence,
has a pre-existing chronic gastrointestinal disease or history of intussusception,
or has a moderate or severe acute illness at the time of the clinic visit. |
|
| Can preterm infants receive RV? |
|
| ACIP recommends the vaccination of a preterm infant if the infant
is at least age 6 weeks, is being or has been discharged from the hospital,
and is clinically stable. |
|
| What is the evidence that RotaTeq
will not be followed by intussusception? |
|
| The clinical trial that led to licensure of RotaTeq included more
than 70,000 infants, and found no evidence of an increased risk of intussusception
in vaccine recipients. Subsequent studies of infants who have received
RotaTeq have found no increase in numbers of cases of intussusception
above what would normally be expected to occur. |
| |
| Reviewed on 5/08 |
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