Every infant should get Rotavirus vaccine. The rotavirus vaccine is a routine childhood vaccination for babies aged 6 to 8 weeks.
The rotavirus vaccination is only suitable for young babies. It protects infants from rotavirus illness that can involve severe diarrhea, often with vomiting, fever and loss of appetite.

Three doses are recommended at these ages:

  • First Dose: 6 weeks of age
  • Second Dose: 10 weeks of age
  • Third Dose: 14 weeks of age

Children should receive all three doses of rotavirus vaccine before they turn one year old. There should be a minimum gap of one month between the doses.

Rotavirus Vaccine is given orally as a liquid straight into the baby's mouth.

The oral vaccine will be given again only if significant volume is spit (more than 50 % of the total dose volume). Re-administration of vaccine is not required if infant spits, vomits or regurgitates a small volume during or after administration of vaccine. The infant should receive the remaining recommended doses as per routine schedule.

The oral vaccine is only licensed for infants up to 12 months of age. Generally Rotavirus diarrhea is not a big problem in older children especially those above two years of age.

They can have all three doses up to 12 months of age at an interval of minimum 4 weeks. In case a dose is missed, it is not necessary to restart the course but it should be completed within the time frame.

This vaccine is not made in eggs and should be safe for babies with general allergies, although any baby with a history of allergy to the vaccine or constituents of the vaccine should not be vaccinated.

There's no reason to postpone the appointment, unless baby is seriously ill with fever or diarrhoea and vomiting. If baby is well enough to have the other routine vaccinations, they can have the rotavirus vaccine.

It's perfectly safe for baby to have the rotavirus vaccine at the same time as other childhood vaccines. It can be safely given during the same doctor’s visit with DTP vaccine, Hib vaccine, IPV, hepatitis B vaccine, and pneumococcal conjugate vaccine. It can safely be given with oral polio vaccine.

Yes it is ok to breastfeed a baby anytime before or after rotavirus vaccination.

Yes. Because the vaccine is given to your baby by mouth, it's possible that the virus in the vaccine will pass through baby's gut and excreted in stools. Hence it can be picked up by whoever changes their nappy. The vaccine contains only a weakened form of the rotavirus, so traces of it in a baby's nappy won't harm healthy people.
However, it could pose a risk for people with a severely weak immune system (such as someone having cancer chemotherapy).
As a precaution, anyone in close contact with recently vaccinated babies should take special care with personal hygiene for two weeks following vaccination, including washing their hands carefully after changing the baby's nappy.

No. Rotavirus isn't the only cause of sickness and diarrhoea in babies, so some may still get unwell. However, rotavirus is the commonest cause of diarrhea in the young babies and therefore the vaccine may prevent most of such cases caused by rotavirus.
The more babies that have the vaccine, the more difficult it will be for the virus to spread.

As with all vaccinations, the schedule should be followed from the actual date of birth, not from the date the baby was due. Therefore, your baby should have the rotavirus vaccine at 6 weeks, 10 weeks and 14 weeks, no matter how premature they were.

All Rotavirus vaccines were tested in large clinical trials that involved thousands of infants, and were found to be safe and effective.

We don't know for sure, but clinical trials have shown that three doses of the vaccine may protect many babies for two years.

A vaccine, like any medicine, can have side effects. These are usually mild and go away on their own.
Most babies who get rotavirus vaccine do not have any side effects. However, there are some side effects or problems that have been reported with rotavirus vaccines in clinical studies (though they were not necessarily caused by the vaccine):

Mild problems following rotavirus vaccines:

  • Babies might become irritable, or have mild, temporary diarrhea or vomiting after getting a dose of rotavirus vaccine.

Serious problems following rotavirus vaccines:

  • With some rotavirus vaccines, a very small risk of intussusception has been reported in some studies. So far this has not been seen with Rotasiil. Intussusception is a type of bowel blockage that is treated in a hospital, and could require surgery. It happens “naturally” in some babies every year, and usually there is no known reason for it.

It is recommended that parents seek medical advice if their baby develops intermittent crying/screaming episodes, start pulling their knees towards their chest, vomiting, or has pink or red coloured jelly-like stools.

For some vaccines, the weakened rotavirus from the vaccine may be found in stools for up to 28 days after the immunisation.

All Rotavirus vaccines protect children against rotavirus diarrhoea. However there are differences in the available rotavirus vaccines. There are two types of vaccines based on the no of stains that they contain –

  1. Monovalent: containing only one strain of rotavirus and
  2. Pentavalent: containing five strains of rotavirus.

Having more strains may offer better coverage against more strains of rotavirus that causes diarrhea though one strain may offer cross protection against the other strains.

G1, G2, G3, G4 and G9 serotypes cause over 90% of rotavirus disease worldwide. Recently, G9 has emerged as the fifth globally common type of rotavirus serotype of clinical importance.

Rotavirus diarrhea itself is a risk to infant. However the severity of the disease varies depending upon the particular strain of the virus that cause it. Recently there are reports that G9 was associated more severity of rotavirus diarrhea. It is associated with a significantly longer duration and higher frequency of diarrhea, longer duration of vomiting, increased hospitalization rate, and more-severe dehydration. The most marked difference was observed for the severe dehydration and, as a likely consequence, the hospitalization rate.

Currently there are 5 brands of Rotavirus vaccines being marketed in India. The brand along with the strains they contain are summarised in table below:

Brand Company Type Strain
ROTATEQ MSD Pentavalent G1, G2, G3, G4, P1A[8]
ROTASIIL Serum Institute Pentavalent G1, G2, G3, G4, G9
ROTARIX GSK Monovalent G1P[8]
ROTAVAC Bharat Biotech Monovalent 116E ( equivalent to G9[11])
ROTASURE Abbott Monovalent 116E ( equivalent to G9[11])

Maintaining a proper storage is a must for vaccine to remain stable and hence effective. Most of the Rotavirus vaccines have to be stored at 2-8oC. Only Rotavac and Rotasure needs a storage temperature of <-20oC.

Rotasiil of Serum Institute of India is the world’s first thermo stable pentavalent Rotavirus vaccine that does not need refrigeration and can be stored below 25oC. This vaccine is highly stable and has undergone various temperature tests and is proven stable when stored < 25oC throughout its shelf life of 30 months.

Yes. Depending on the strains that they contain and other technical factors, each vaccine has a different efficacy against rotavirus. However, almost all rotavirus vaccines show better efficacy in developed countries compared to that in developing countries. Since Rotavirus disease is a disease that has different presentation based on the prevalent strains, the efficacy seen in one country may not be the same in the other.

Based on the studies in India, both Indian rotavirus vaccines have shown reasonably good efficacy. Rotasiil from Serum Institute of India has shown an excellent efficacy against very severe diarrhea. This is significant because it is the most severe form of rotavirus that causes maximum hospitalization and deaths of infants.

Rotavirus cannot survive in the acidic media of stomach. To keep vaccine effective and to protect the attenuated viruses present in the vaccine from getting killed in the stomach acid, the acid needs to be neutralized and brought to a pH where the vaccine virus can survive. This is done by using buffer as diluents for the vaccines. Different types of buffers are required in different volumes to get this pH. Since different vaccines use different buffers they have different volumes.

If the oral vaccines are sweet and palatable, infants do not have any problem taking it. Also, dosing volume of many of the syrups commonly used in infants can be up to 5 ml and these volumes are within acceptable limits.