Rotavirus vaccine should not be given to infants with acute moderate or severe gastroenteritis until the condition improves.
If a dose of rotavirus vaccine is regurgitated or vomited, a repeat dose should not be given. Remaining doses should be administered as recommended.
Rotavirus vaccine should not be given to infants with a history of a severe allergic reaction after a previous dose or to a vaccine component. RV5 is preferred over RV1 in infants with or at risk of latex allergy (eg, with spina bifida or bladder extrophy) as the RV1 applicator contains latex.
Rotavirus vaccines should not be given to infants with a history of an uncorrected congenital malformation of the gastrointestinal tract that would predispose the infant to intussusceptions2 (see section 17.7.1).
Rotavirus vaccine should not be given to infants with severe combined immune-deficiency syndrome.42
Rotavirus vaccine can be administered to infants with a mild illness, including gastroenteritis and upper respiratory tract infections.
Because both rotavirus vaccines are live attenuated, the safety of immune-compromised patients and their contacts is an important consideration. Shedding of vaccine virus in the stool is possible, and is more likely with RV143 and in immune-compromised patients (eg, children with HIV). The vaccine virus could then be transmitted to unvaccinated populations, a feature that is generally beneficial as it promotes herd immunity.
So far there are no safety concerns, but there is also no data to confirm the safety of these vaccines for immune-compromised patients. The potential risk of transmission of vaccine virus should be weighed against the risk of acquiring and transmitting natural rotavirus. Contacts of vaccinees should observe careful hygiene measures when changing infants’ nappies.44