Rotavirus Vaccines

Drug Levels and Effects:




Summary of Use during Lactation:


Rotavirus vaccines are used only in infants and are not indicated for use in women of childbearing age. Breastfeeding protects infants against acute gastroenteritis caused by rotavirus.[1] However, breastfeeding can affect theimmuneresponse of an infant to rotavirus vaccines.[2][3][4][5] The extent of the effect depends on the maternal anti-rotavirus antibody titer in breastmilk with higher titers found in less developed countries.[6][7] In a European study, no difference in rotavirus infection rates during the first season was seen between infants who were breastfed and formula-fed infants when they received rotavirus vaccination. In the second season, protection against infection was slightly less in breastfed infants.[5] Withholding breastfeeding for up to 2 hours before and after vaccine administration would likely minimize the interference.[6][8]


Drug Levels:


Maternal Levels.

Relevant published information was not found as of the revision date.

Infant Levels.

Relevant published information was not found as of the revision date.


Effects in Breastfed Infants:


A subset of 300 infants in a multicenter European rotavirus efficacy trial had antirotavirus IgA titers measured 1 to 2 months after the second rotavirus dose (Rotarix - GSK). Breast-fed infants had an 85.5 % conversion rate compared with 89.2 % rate in exclusively formula-fed infants, which was not statistically different. The serum antirotavirus IgA concentrations were 185.8 units/mL and 231.5 units/mL in the breastfed and exclusively formula-fed infants, respectively.[5]


Possible Effects on Lactation:


Relevant published information was not found as of the revision date.


References:


1. Plenge-Bonig A, Soto-Ramirez N, Karmaus W et al. Breastfeeding protects against acute gastroenteritis due to rotavirus in infants. Eur J Pediatr. 2010;169:1471-6. PMID:20617343
2. Rennels MB. Influence of breast-feeding and oral polio vaccine on the immunogenicity and efficacy of rotavirus vaccines. J Infect Dis. 1996;174 (Suppl 1):S107-11. PMID:8752299
3. Goveia MG, Dinubile MJ, Dallas MJ, Heaton PM, Kuter BJ. Efficacy of pentavalent human-bovine (WC3) reassortant rotavirus vaccine based on breastfeeding frequency. Pediatr Infect Dis J. 2008;27:656-8. PMID:18520448
4. Pichichero ME. Effect of breast-feeding on oral rhesus rotavirus vaccine seroconversion: a metaanalysis. J Infect Dis. 1990;162:753-5. PMID:2167344
5. Vesikari T, Prymula R, Schuster V et al. Efficacy and immunogenicity of live-attenuated human rotavirus vaccine in breast-fed and formula-fed European infants. Pediatr Infect Dis J. 2012;31:509-13. PMID:22228235
6. Moon SS, Wang Y, Shane AL et al. Inhibitory effect of breast milk on infectivity of live oral rotavirus vaccines. Pediatr Infect Dis J. 2010;29:919-23. PMID:20442687
7. Chan J, Nirwati H, Triasih R et al. Maternal antibodies to rotavirus: Could they interfere with live rotavirus vaccines in developing countries? Vaccine. 2011;29:1242-7. PMID:21147127
8. Foster RH, Wagstaff AJ. Tetravalent human-rhesus reassortant rotavirus vaccine: a review of its immunogenicity, tolerability and protective efficacy against paediatric rotavirus gastroenteritis. BioDrugs. 1998;9:155-78. PMID:18020551



Substance Identification:




Substance Name:

Rotavirus Vaccines

Drug Class:


  • Vaccines

  • Viral Vaccines


  • Administrative Information:




    LactMed Record Number:


    733


    Last Revision Date:


    Disclaimer:Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.