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.


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:


    Last Revision Date:

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