Rotavirus vaccine

Key points about rotavirus vaccine

  • Rotavirus vaccine is free in Aotearoa New Zealand for babies at 6 weeks and 3 months. 
  • The vaccine protects against rotavirus infection. 
  • The rotavirus vaccine is commonly called Rotarix®.
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Rotavirus vaccine is used to prevent rotavirus infection. The current rotavirus vaccine used in Aotearoa New Zealand is called Rotarix®. Rotarix is available as a liquid and is given as drops to make it easy for your baby to swallow. The vaccine helps your baby build immunity, so when they come into contact with the virus they will not get rotavirus infection.

Almost all unimmunised children will get rotavirus before they are 3 years old. Vaccination is the best method for preventing rotavirus infection and reducing the seriousness of illness if infected. Vaccination against rotavirus will protect around 8 out of 10 babies from severe rotavirus infection and needing to be admitted to hospital because of rotavirus infection.

If your baby/pēpi has already had rotavirus gastroenteritis, they should still receive the full course of immunisation because it will provide better protection against getting rotavirus again.  

The rotavirus vaccine is given as 2 doses when babies are 6 weeks and 3 months.

If you miss these dates, you can catch up, but the first vaccine must be given before 15 weeks of age and the second dose before 25 weeks. The interval between the 2 doses should be at least 4 weeks. 

The first vaccination of the rotavirus vaccine should not be given after 15 weeks of age and no vaccination should be given after 24 weeks. The vaccine is not given to babies older than these ages because of the increased risk of side effects.

  • There is a very small chance (between 1 and 6 in every 100,000 babies vaccinated) that the first dose of the rotavirus vaccine might also cause this blockage to develop. To reduce the risk of this happening, the first dose of the vaccine will not be given to babies older than 15 weeks of age.
  • As babies get older, some (about 1 out of 1,000) get a condition called intussusception that causes a blockage in their lower gut. It is extremely rare before 3 months of age and most cases occur between 5 months and a year. Read more about bowel blockage below.

As mentioned above, the first vaccination should not be given after 15 weeks of age and no vaccination should be given after 24 weeks. The vaccination should not be given to babies who:

  • Have severe combined immune deficiency (SCID), a rare genetic disease that makes babies very vulnerable to infection.
  • Have had a bad reaction to a previous dose of the vaccine, or to any of the ingredients that go into the vaccine.

If your child currently has an illness with vomiting and diarrhoea, the vaccine may be delayed. 

Rotavirus vaccine is available as liquid drops that are simply squirted into your baby’s mouth (a dose of 1.5 mL). If your baby spits out their dose, another dose is not necessary. 

As with all vaccinations, you will need to stay with your child at the doctor's surgery or clinic for a short time after they have had the vaccination to make sure they have not had an allergic reaction to the vaccine. 

Feeding: You can feed your baby breast milk, formula or food after their vaccination. 
Risk of rotavirus disease from having the vaccine: Your baby will not get the rotavirus disease from the vaccine. The virus in the vaccine is weakened so it mimics the disease but does not cause infection. 
Vaccine virus is excreted in stools (poo): The weakened rotavirus from the vaccine may be found in your baby's poo for up to 28 days after the first immunisation and up to 15 days after the second dose. After your baby gets the vaccine, follow standard hygiene measures when changing their nappies. This includes washing your hands using soap and water and drying them well, or using liquid hand gel.
Nappies: Your baby can wear cloth or disposable nappies after immunisation. No special precautions need to be taken when washing cloth nappies.
Kissing your baby on the mouth: No studies have investigated transmission of vaccine virus from kissing a baby on the mouth after immunisation. However, it is theoretically possible for a person to be exposed to weakened vaccine virus in this way.
Attending day care: Your baby can attend day care after having the vaccine. Caregivers also need to use standard hygiene measures and wash and dry their hands well after changing nappies.
Swimming: Your baby can go swimming after they have had the vaccine.

Like all medicines, rotavirus vaccine can cause side effects, although not everyone gets them. Common side effects include restlessness and irritability. Some babies may have mild diarrhoea (runny poos), vomiting or tummy pain. This is temporary and usually settles after a few days. Wash your hands well after changing nappies.


Risk of bowel blockage

Rotavirus vaccine may rarely cause a bowel blockage called intussusception. This occurs naturally in some babies each year, with no known cause. Intussusception is rare and can be treated in hospital. Signs include severe crying, tummy pain (pulling up their knees) and pink- or red-coloured jelly-like poos.

If your baby has these symptoms, contact your doctor immediately. The increased risk, if any, is very small compared to the risks of rotavirus infection and is most likely to occur within the first week after the first dose, but may be seen up to 3 weeks after vaccination.

Intussusception, although rare, generally occurs in older infants. Therefore, it's very important to give the vaccine at the correct ages of 6 weeks and 3 months, before they reach the high risk period. If your child has a history of intussusception or severe stomach (tummy) problems, let your doctor know before giving the rotavirus vaccine. 

Did you know that you can report a side effect to a medicine to CARM (Centre for Adverse Reactions Monitoring)? Report a side effect to a product.(external link)

The best place to go for vaccinations is your family medical clinic. They have your medical records and can check to see if you’ve already had a particular vaccination. Either your doctor or a nurse can give the vaccination.

If you don’t have a family doctor, you can go to one of the after-hour medical clinics. Ring them first to make sure they can help you with the vaccination you need.

You can find a clinic near you on the Healthpoint(external link) website. Put in your address and region, and under Select a service, click on GPs/Accident & Urgent Medical Care.

Vaccines on the National Immunisation Schedule(external link) are free. Other vaccines are funded only for people at particular risk of disease. You can choose to pay for vaccines that you are not eligible to receive for free.

The following links have more information on rotavirus vaccine. 

Rotarix(external link) Immunisation Advisory Centre, NZ
Rotarix(external link) Medsafe Consumer Information, NZ
Immunise against rotavirus – protect your child(external link) Ministry of Health, NZ, 2017

  1. Rotavirus(external link)(external link) Immunisation Handbook 2020, NZ
  2. Rotarix(external link)(external link) The Immunisation Advisory Centre, NZ

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Reviewed by: Maya Patel, MPharm PGDipClinPharm, Auckland

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