Summer 2009

ACIP issues new guidelines to prevent rotavirus gastroenteritis among infants and children

According to the Centers for Disease Control and Prevention (CDC), rotavirus is the most common cause of severe gastroenteritis in infants and young children worldwide. Rotavirus gastroenteritis results in relatively few childhood deaths in the United States (approximately 20 to 60 deaths per year among children under 5 years of age)¹. However, nearly every child in the United States is infected with rotavirus by age 5; and the majority will have gastroenteritis, resulting in approximately 410,000 physician visits, 205,000 to 272,000 emergency room visits, and 55,000 to 70,000 hospitalizations each year.

The Advisory Committee on Immunization Practices (ACIP) recommends the use of a live, oral, human-bovine reassortant rotavirus vaccine (RotaTeq^®, produced by Merck and Company, Whitehouse Station, New Jersey) that was licensed in February 2006 by the Food and Drug Administration (FDA) for use among U.S. infants.

ACIP recommends routine vaccination of U.S. infants with three doses of rotavirus vaccine administered orally at ages 2, 4 and 6 months. The first dose should be administered between the ages of 6 weeks and 12 weeks. Subsequent doses should be administered at four to 10 week intervals, and all three doses of vaccine should be administered by age 32 weeks.

Infants who are being breastfed can receive the rotavirus vaccine. The efficacy of rotavirus vaccine is similar among breastfed and nonbreastfed infants. Like other vaccines, rotavirus vaccine can be administered to infants with transient, mild illnesses, and with or without low-grade fever.

Rotavirus vaccine can be administered together with DTaP, Hib vaccine, IPV, hepatitis B vaccine and pneumococcal conjugate vaccine. Available evidence suggests that the rotavirus vaccine does not interfere with the immune response to the Hib vaccine, IPV, hepatitis B vaccine, and pneumococcal conjugate vaccine and the diphtheria and tetanus antigens in DTaP.