Rotarix Vaccine: When Is the Rotavirus Vaccine Given and How Many Doses?

Rotarix is an oral vaccine used to protect babies against diarrhoea and vomiting caused by rotavirus. Timing is especially important when planning vaccinations in infancy, because the course must be completed within specific age limits. In this article I explain rotavirus infection, the features of the Rotarix vaccine, the dosing schedule and the points parents should know.

“I am very careful about my baby’s hygiene; is the rotavirus vaccine still necessary?” is a good starting point for understanding the topic. Handwashing and cleanliness are important, but on their own they may not be enough against this easily spread virus. The aim of vaccination is to help protect the baby, especially from severe diarrhoea and fluid loss.

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What is rotavirus and what symptoms does it cause in babies?

Rotavirus is a virus that causes gastrointestinal infection, particularly in babies and young children. The infection usually presents with vomiting and watery diarrhoea; fever and abdominal pain may also be present.

For parents, the most important aspect of the illness is that a baby can lose a large amount of fluid in a short time. In a baby who cannot feed properly because of vomiting, replacing the fluid lost through diarrhoea can become difficult.

Signs that suggest fluid loss include:

• Fewer wet nappies than usual
• Dry mouth
• Fewer tears when crying
• Unusual sleepiness or marked irritability
• Reduced feeding

If these signs develop, medical assessment is needed. Antibiotics are not effective against rotavirus infection; preventing and correcting fluid loss is the cornerstone of treatment. ^[1]

How is rotavirus transmitted?

Rotavirus spreads into the environment through the stool of an infected person. Putting hands to the mouth after touching contaminated hands, toys or surfaces can lead to infection. For this reason, infection can occur not only in children who attend nursery but also in babies cared for at home.

Hand hygiene and cleaning after nappy changes are important parts of prevention. However, good hygiene does not completely prevent the spread of the disease. Vaccination is a form of protection that complements everyday hygiene measures. ^[1]

What is the Rotarix vaccine?

Rotarix is a vaccine containing live attenuated human rotavirus. It helps the immune system recognise the virus and build a response against an infection it may encounter later.

How is the Rotarix vaccine given?

Rotarix is not injected; it is given by mouth. In this respect it differs from many childhood vaccines. It is administered by a healthcare professional, and the vaccine must never be given by injection.

Where appropriate, it can be given at the same visit as other childhood vaccines. This allows the baby’s vaccination schedule to be planned as a whole. ^[2]

At what age is Rotarix given and how many doses are needed?

Rotarix is a two-dose vaccine. According to the European product information, the first dose can be given from 6 weeks of age, and there must be at least four weeks between the two doses.

The course should preferably be completed before 16 weeks of age and in any case by 24 weeks. That is why it is important to discuss the rotavirus vaccine at the baby’s first check-ups.

A “let’s wait until the baby is a bit older” approach may not be suitable for this vaccine. Once the age limit has passed, catch-up vaccination is not freely possible as it is with other vaccines. A schedule should be created based on the baby’s date of birth and previous doses, in line with the current information for the product used in Turkey. ^[2]

How well does the Rotarix vaccine protect?

The most important benefit of rotavirus vaccines is that they reduce the risk of severe illness and hospitalisation. The CDC reports approximately 85–98% protection against severe illness and hospitalisation in the first year of life for rotavirus vaccines. These figures do not guarantee the same result for every child or in every situation.

A vaccinated baby can still get diarrhoea, because diarrhoea has many causes other than rotavirus. In addition, no vaccine can completely prevent the targeted infection in every person. When judging the vaccine’s success, protection from severe illness in particular should be considered. ^[3]

What are the side effects of the Rotarix vaccine?

Irritability and mild diarrhoea may occur after Rotarix. A very rare risk that parents should be aware of is intussusception, in which one part of the intestine slides into another.

Urgent assessment is needed if severe or intermittent abdominal pain, repeated vomiting, bloody stools or marked abdominal swelling develop, especially in the first week after vaccination. These signs should not be dismissed as “a normal effect of the vaccine”.

Rotarix is not given to babies who have had intussusception before, who have an uncorrected intestinal malformation that predisposes to it, or who have severe combined immunodeficiency. ^[4]

Frequently asked questions about the Rotarix vaccine