Open your Facebook app (or depending on which generation you’re from – Twitter, TikTok, newspaper) and the one thing that grabs the news headline nowadays: the Covid-19 vaccine.
If you’re interested in learning about the Covid-19 vaccine and how Malaysia plans to vaccinate at least 60% of the population, read our articles here and here.
With that being said, we would like to talk about another vaccine today, of which it is given by...mouth?!
Rotavirus at a glance
Viruses are all the hype nowadays, thanks to Covid-19. But this virus right here, called rotavirus, is a different one. Rotavirus is known and named for the wheel-like appearance (rota means wheel in Latin) when viewed under electron microscopy. Well, rota also sounds like ‘roda’, which means wheel in Malay, coincidence?
Image credit: Bryon Skinner via CDC/ Dr. Erskine Palmer
This ‘roda’ virus spreads easily among babies and young children. Almost all children who were infected by rotavirus aged 5 years old and below. Fun fact: Older children and adults also can get sick from rotavirus. It’s’ just that adults who get rotavirus disease tend to have milder symptoms.
The virus can cause gastroenteritis, which can manifest as severe watery diarrhea, vomiting, fever, and abdominal pain. Rotavirus spreads easily from hand-to-mouth due to contact with stools from an infected person. Most of the children recover on their own from the infection. Children who get rotavirus disease can become dehydrated and may need to be hospitalized. In Malaysia, about 22% to 50% cases of all diarrhoea in children are caused by rotavirus.
Fortunately, the infection can be prevented through vaccination!
Rotavirus vaccination
In addition to vaccinations mandated by the Ministry of Health Malaysia, most paediatricians will recommend babies who are aged at least 6 weeks to receive a rotavirus vaccination. It is not a mandatory vaccine that included in our national immunisation programme. Rotavirus vaccination may be given from age 6 weeks to 32 weeks depending on the type of vaccine given, in the objective to prevent diarrhea and vomiting caused by rotavirus.
How is rotavirus vaccination given to babies?
Whenever we mention vaccination, the first thing that comes to our mind is that scary needle injection.
The struggle is real when you try to get your young children to be vaccinated. Well good news, rotavirus vaccine is given by mouth only! The vaccine is given by putting drops in the child’s mouth. Hurray! No more throwing tantrums and embarrassing cries in the clinic.
As we alluded earlier, when and how many doses the baby receives depends on the types of the rotavirus vaccine. Commonly, there are two types of rotavirus vaccine:
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Live attenuated monovalent rotavirus vaccine (Brand name: Rotarix®), which is given in 2 doses. The first dose may be administered from the age of 6 weeks. There should be an interval of at least 4 weeks between doses. The vaccination course should be completed by the age of 24 weeks.
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Live pentavalent human-bovine reassortant rotavirus vaccine (Brand name: RotaTeq®), which is given in 3 doses. The 1st dose of RotaTeq should be administered at 6-12 weeks of age; the subsequent doses should be administered at a minimum interval of 4 weeks between each dose. The vaccination course should be completed before 32 weeks of age.
We won’t get into the hard science of what makes both of them different from each other (they’re very similar actually). Here are what you need to know about these two vaccines:
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Both vaccines demonstrate similarly high levels of protection against severe rotavirus gastroenteritis. In clinical trials vaccination reduced the rate of severe rotavirus gastroenteritis by 85% to 98%, and the rate of hospitalisation for gastroenteritis of any cause by 42% to 59%. (1,2) So no, there is no evidence that one oral rotavirus vaccine is more effective than the other. Either one is fine.
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Rotarix and RotaTeq are not interchangeable. Babies who receive a first dose of either vaccine should complete the entire course of vaccination using the same oral rotavirus vaccine.
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Oral rotavirus vaccination protects most young children against severe dehydrating rotavirus gastroenteritis that most commonly occurs between 3 and 35 months of age. It does not provide lifetime protection. However, as we mentioned earlier, because rotavirus infection in older children and adults is less common and causes milder symptoms, this is not a huge concern.
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If the baby is given Rotarix (2-dose), in case if the baby spits out or regurgitates most of the vaccine dose, a replacement dose may be given at the same vaccination visit. However, do not repeat the dose if the baby spits out or regurgitates when he/she is administered with a Rotateq (3-dose). The baby should continue to receive any remaining doses of vaccine according to schedule.
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Rotavirus vaccines can be given together with other recommended vaccinations such as those listed in the national immunization plan.
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Another virus called porcine circovirus (or parts of it) can be found in rotavirus vaccine. This virus does not infect people, and there is no known safety risk.
Image credit: https://www.cdc.gov/vaccines/vpd/rotavirus/index.html
Rotavirus vaccination is effective...and safe!
Rotavirus vaccines have strong safety records, including clinical trials involving tens of thousands of patients as well as clinical experience with millions of recipients.
If you are still sceptical about the safety of vaccination, talk to a healthcare professional who you trust.
Nonetheless, just like every medicine and vaccine under the sun, there is always a very small group of users who may experience some side effects. Good news is, the side effects associated with rotavirus vaccine are usually mild and temporary. The most common side effects include diarrhoea, vomiting and increased irritability.
However, there is also a small chance of serious allergic reaction with signs and symptoms such as rashes, swelling of the face and throat, difficulty in breathing, increased heartbeat, dizziness and weakness.
In very, very, very rare scenarios, the babies experience bowel blockage (intussusception). Parents are advised to observe the baby if the baby develops signs and symptoms such as stomach pain with severe crying, persistent vomiting, blood in stools, a swollen belly and/or high fever.
Precautions
Rotavirus vaccine is effective, as demonstrated by rigorous clinical trials we mentioned above. Nonetheless, like other vaccines, no vaccine is 100 percent effective and rotavirus vaccine is no exception. Also, these vaccines will not provide protection against diarrhoea and vomiting caused by germs other than rotavirus.
Parents are advised to talk to a healthcare professional before giving rotavirus vaccine to their child if:
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A baby has received blood transfusion or blood product including immunoglobulin within 6 weeks.
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A baby has any chronic gastrointestinal disease.
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A baby has close contact such as a household member who has a weakened immune system.
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A baby has growth problems.
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A baby has any disease or is on any medicines that may reduce his/her immune system against infection.
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A baby has HIV/AIDS, or any other disease that affects the immune system.
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A baby has treatment with drugs such as steroids.
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A baby has cancer, or cancer treatment with x-rays or drugs.
Infants should not get rotavirus vaccine if they have any of the following:
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a severe (life-threatening) allergic reaction to an earlier dose of rotavirus vaccine,
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a severe (life threatening) allergy to any component of rotavirus vaccine. Tell your doctor if your baby has any severe allergies that you know of, including a severe allergy to latex,
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severe combined immunodeficiency (SCID), a condition in which a child’s immune system cannot fight infections, or
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a previous episode of a type of bowel blockage called intussusception.
A word from Doc2Us
If your child does not belong to any of the above groups, there is really no reason to not let your child receive a rotavirus vaccine. Almost all babies who get rotavirus vaccine will be protected from severe rotavirus diarrhea, and all it takes is just a few drops of vaccine into the mouth.
If you have any questions related to rotavirus vaccine, you can consult our professional doctors and healthcare professionals on Doc2Us. Doc2Us is a mobile application that allows you to talk to a doctor or any healthcare professionals via text chat at any time and from anywhere.
Download Doc2Us app on Apple App Store, Google Play Store and Huawei App Gallery; or use our web chat at https://web.doc2us.com/
Till then, stay at home and take care!
Disclaimer: As a service to our users and general public, Doc2Us provides health education contents. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
