Summary:

  • Rotavirus is extremely common and contagious, affecting most children by the age of 3.
  • It causes prolonged vomiting and diarrhea and often dehydration, causing a great deal of hospitalizations in the U.S. In developing countries, it is a leading cause of death in children.
  • RECOMMENDED

What is rotavirus?

Rotavirus is the leading cause of vomiting and diarrhea (gastroenteritis) in the United States and worldwide. The peak season for rotavirus on the East Coast is typically from March to April each year. At that time we see numerous infants and toddlers every day with vomiting and diarrhea. Fortunately, it is a rather benign illness so long as children do not get dehydrated.

Rotavirus is extremely common; virtually all children will catch it by the time they are two or three years old. Each year in the United States over 2.7 million children under 5 catch rotavirus, resulting in over 400,000 doctor and 200,000 emergency room visits, 55,000-70,000 hospitalizations and 20-60 deaths. Overseas in developing countries, rotavirus is a leading killer of children causing over 600,000 deaths each year.

The virus is very contagious and stable in the environment; it can live on surfaces for weeks or months if not disinfected.

Infection does not confer permanent immunity; children and adults can become re-infected, but is usually much milder each time.

Before the vaccine, almost every child less than 5 would catch the disease. Improved sanitation has made no difference in spread of disease. Improved survival rates in developed countries are due to better nutrition and medical care.

The vaccine

In February 2006, the FDA approved a new, extensively studied vaccine to prevent rotavirus. That same month, the committee which makes vaccine recommendations unanimously voted to make this vaccine part of the recommended childhood vaccine schedule. The vaccine is given orally at 2, 4, and 6 months of age; since it is an oral vaccine, it does not increase the number of “shots” (with a needle) that infants receive. Studies show that the vaccine will prevent about 75% of rotavirus infections and 95-98% of the most severe cases, which often require hospitalization. Older infants and toddlers can also receive the vaccine, so long as they start it by 24 months of age and complete it by 32 months of age.

What are the side effects?

In a study of 70,000 infants who received the vaccine, there were no side effects compared with infants who did not receive the vaccine. Theoretically, the vaccine could cause mild vomiting, diarrhea, poor feeding or fussiness, but again there was no more of these symptoms in children receiving the vaccine compared with those who did not.

The vaccine, and the disease, can cause an intestinal condition called inussusception. Extensive population-based studies have determined that the vaccine is no more likely to cause intussusception than the disease itself.

Risks vs. benefits

Every winter we see hundreds of children with rotavirus, with moderate to severe vomiting and diarrhea for a week or more. Almost all children get it, and many are hospitalized for dehydration. On the other hand, the disease has no long-term effects and almost all children recover quite nicely. The risks of the disease outweigh the risks of the vaccine. In this country, this vaccine at this point it is somewhat up to the parents, their particular situation, and his or her philosophy of vaccines and disease. Infants and toddlers in daycare or around other children very often are definitely at increased risk of rotavirus. Children are definitely miserable when they are sick with this virus, some are hospitalized, some suffer long-term effects. Parents often miss a week of work or more. Each parent should weigh the risks and benefits for their child and make an informed decision about the rotavirus vaccine.

Resources

Rotavirus Vaccine Information Statement (VIS) (CDC)

References

 

Published Sept. 8, 2006. Last updated November 5, 2016.