Rotavirus vaccination in children

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Rotaviruses are one of the most common causes of diarrhea and vomiting in children. Since the pathogens are very contagious, almost all children fall ill in the first 5 years of life – most by the age of 2 years.
Especially in infants, a large loss of fluid and salt due to vomiting diarrhea can quickly lead to dangerous dehydration. If the water loss is too high, the children must be treated in the hospital. To avoid this, preventive oral rotavirus vaccination is recommended for all infants as early as possible.

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The Standing Commission on Vaccination (STIKO) recommends oral vaccination against rotavirus for infants. The first inoculation should be done from the completed 6. Weeks of life and be completed by 12 weeks of age at the latest.

The vaccination series should be completed, depending on the vaccine, preferably by the age of 16 weeks or by the age of 22 weeks. Vaccination must be administered no later than 24 weeks of age or by the time the child is 2 years old. 32 weeks should be finished.

Rotaviruses: Infection

The pathogens are found in the gastrointestinal tract of sick people. Transmission is possible as long as the viruses are excreted in the stool. As a rule, this lasts up to 8 days, in individual cases the pathogens can be excreted even longer.

Transmission is mainly by smear infection. The viruses are passed on through the smallest stool residues on the hands and can pass from the hand into the mouth (stool-hand-mouth). In addition, infection is also possible via contaminated objects such as toys or door handles, as well as via food and drinking water. This is because the pathogens can survive in the environment for several days. Since even thorough hand washing and disinfection cannot completely prevent infection with rotaviruses, vaccination offers the best protection for infants.

Rotaviruses: course of disease

After infection with rotavirus, it usually takes 1 to 3 days before watery diarrhea and sudden vomiting and abdominal pain set in. Mild fever, cough and cold also occur frequently. The symptoms last for about 2 to 6 days. Severe courses can result in rapid loss of fluids.

In Germany, infants and toddlers up to the age of 2 weeks are most frequently vaccinated. year of life. Rotavirus infections are often more severe in infants, so that more than half of them in Germany have to be treated in hospital. Deaths occur only extremely rarely in Germany.

Especially between February and April, gastrointestinal illnesses caused by rotaviruses regularly accumulate in Germany.

Rotaviruses: Vaccination

Since July 2013, the Standing Commission on Vaccination (STIKO) has recommended oral vaccination against rotavirus for all infants 6 weeks of age and older. If possible, it should be started by the age of 12 weeks.

Depending on which vaccine is used, 2 or 3 doses of vaccine are needed at a minimum interval of 4 weeks. Depending on the vaccine, the vaccination series should be completed by 16 weeks of age, if possible, or by 22 weeks of age – but no later than 24 weeks of age or. 32 weeks.

Vaccines against rotaviruses have been available in Germany since 2006. It is a so-called live vaccine. This means that the vaccine contains attenuated rotaviruses, which, however, do not trigger the disease. Numerous studies have shown that vaccination is effective in preventing severe illness and hospitalization due to rotavirus disease.

The oral vaccine can also be given at the same time as other vaccinations given to infants (e.g., immunization against rotavirus). B. from the 8th week of life. The first week of life together with the sixfold vaccination).

Possible vaccination reactions and side effects

The oral vaccination against rotaviruses is generally well tolerated. Due to the stimulation of the body’s defenses, temporary fever, diarrhea or vomiting may occur more frequently after vaccination and the infant may be more irritable for a short time. Occasionally a cold, abdominal pain or flatulence have been observed after vaccination. Rarely to very rarely, side effects such as blood in the stool, skin rash, or a middle ear infection may occur.

After the first partial vaccination, there may be a slightly increased risk of intussusception of one intestinal segment into another. This intestinal invagination is medically called intussusception. According to current knowledge, about 1 to 2 additional intussusceptions may occur per 100.000 vaccinated children occur. Because the likelihood of intussusception in infants generally increases with months of life, it is recommended that the vaccination series be started as early as possible and completed in a timely manner.

Children with a predisposition for such intussusception should not receive the vaccination. Congenital or suspected immunodeficiency may also argue against vaccination.

Please discuss the vaccination and suitable vaccination dates during your child’s first U-examinations. For premature babies, your pediatrician will also advise you. Your pediatrician on how to vaccinate.

Rotaviruses: Frequently asked questions and answers (FAQs)

Can I breastfeed my child after rotavirus vaccination??

Yes. However, as a precaution, it is recommended not to breastfeed for about 1 hour before and 1 hour after oral vaccination, as this could potentially affect the effectiveness of the vaccine. During this period, it may be necessary to switch to other fluids.

What is intestinal intussusception (intussusception) after rotavirus vaccination?

Intestinal intussusception is a very rare side effect that can occur after rotavirus vaccination (about 1 to 2 additional cases per 100.000 vaccinated children). However, if severe abdominal pain, persistent vomiting and/or bloody stools occur during the first week after the oral vaccination, you should have your child examined by a doctor immediately.

Who pays for the cost of rotavirus vaccination?

The Permanent Vaccination Commission (STIKO) recommends the rotavirus vaccination for all infants since July 2013. This recommendation is the basis for the vaccination guideline of the Joint Federal Committee (G-BA), which determines the scope of protective vaccinations as a mandatory benefit of statutory health insurance. Since February 2014, the rotavirus vaccination is included in the protective vaccination guidelines. This means that all public health insurances cover the costs of the vaccination for the recommended age group.
For privately insured persons, the costs are covered according to the contract.

Can my child get sick with diarrhea despite rotavirus vaccination?

The vaccination only provides protection against diarrheal diseases caused by rotaviruses. Rotaviruses can cause severe vomiting diarrhea in infants and small children, which not infrequently need to be treated in the hospital. However, the vaccination does not protect against diarrhea caused by other pathogens of gastrointestinal diseases or by intolerances.

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