17 Rotavirus

17.6 Contraindications and precautions

17.6.1 Contraindications

17.6.2 PrecautionsTop

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