All infants are recommended to receive a course of oral rotavirus vaccine before they are 6 months old.
Infants can receive the 1st dose of rotavirus vaccine as early as 6 weeks of age (see Table. Upper age limits for dosing of oral rotavirus vaccines). Infants should receive the next scheduled rotavirus vaccine dose(s) according to Table. Upper age limits for dosing of oral rotavirus vaccines.
Infants and children >6 months of age should not receive rotavirus vaccines.
|Vaccine||Doses||Age of routine administration||Age limit for 1st dose||Age limit for 2nd dose||Age limit for 3rd dose||Minimum interval between doses|
|Rotarix (GlaxoSmithKline Australia)||2 oral doses (1.5 mL/dose)||2 and 4 months||6–14 weeks (before turning 15 weeks of age)||10–24 weeks (before turning 25 weeks of age)||Not applicable||4 weeks|
|RotaTeq (Merck Sharp & Dohme)||3 oral doses (2 mL/dose)||2, 4 and 6 months||6–12 weeks (before turning 13 weeks of age)||10–32 weeks (preferably before turning 28 weeks of age, to allow at least 4 weeks between the 2nd and 3rd doses)||14–32 weeks (before turning 33 weeks of age)||4 weeks|
Rotarix (human monovalent rotavirus vaccine)
The vaccination course of Rotarix is 2 doses, at 2 and 4 months of age:
- Give the 1st dose between 6 and 14 weeks of age — that is, before turning 15 weeks old.
- Give the 2nd dose by 24 weeks of age — that is, before turning 25 weeks old.
- Ensure that the interval between the 2 doses is at least 4 weeks.
RotaTeq (pentavalent human–bovine reassortant rotavirus vaccine)
The vaccination course of RotaTeq is 3 doses, at 2, 4 and 6 months of age:
- Give the 1st dose between 6 and 12 weeks of age — that is, before turning 13 weeks old.
- Give the 2nd dose at least 4 weeks later.
- Give the 3rd dose by 32 weeks of age — that is, before turning 33 weeks old.
- Ensure that the interval between doses 2 and 3 is at least 4 weeks.
For infants receiving their 2nd dose after reaching 29 weeks of age and before turning 33 weeks of age, this 2nd dose will also be their final dose.
Receiving the 1st dose after the age cut-off
Infants should start the course of rotavirus vaccination within the recommended age limits for the 1st dose — that is:
- before 15 weeks of age for Rotarix
- before 13 weeks of age for RotaTeq
If an infant inadvertently receives the 1st dose of rotavirus vaccine after this age, they can receive the remaining vaccine doses as per the schedule if they did not have intussusception after the first dose. Maintain the minimum interval between doses within the recommended age limits for later doses.
The timing of the 1st dose should not affect the safety and efficacy of the 2nd and 3rd doses.1
Completing the schedule after rotavirus infection
Infants who develop rotavirus gastroenteritis before receiving the full course of rotavirus vaccine should still complete the full 2- or 3-dose schedule. One rotavirus infection only provides partial immunity.1
Preterm infants are recommended to receive either rotavirus vaccine starting at the chronological age of at least 6 weeks, if the infant is clinically stable. Do not correct the age for prematurity.
Preterm infants (born at <37 weeks gestation) appear to have a higher risk of hospitalisation from viral gastroenteritis.2,3
See also Vaccine information.
Vaccinating hospitalised infants, including hospitalised preterm infants, has a low risk of transmitting vaccine viruses if standard infection control precautions are maintained.4
See Contraindications and precautions for more details about hospitalised infants and other special risk groups.
Infants’ consumption of food and liquid
There are no restrictions on the infant’s consumption of food or liquid, including breast milk, before or after vaccination with either rotavirus vaccine.1,5
Infants living in households with pregnant women
Infants living in households with pregnant women can receive rotavirus vaccines. Most pregnant women will have immunity to rotavirus. However, vaccinating infant contacts may benefit adults, including pregnant women, by protecting them from transmission of wild-type infection. Vaccination outweighs any theoretical concern about exposure to vaccine viruses.