AskDrSears - The Vaccine Book: Second Rotavirus Vaccine Now Available and the Timing of the Doses has been Expanded

Second Rotavirus Vaccine Now Available and the Timing of the Doses has been Expanded

Tuesday, October 7, 2008

Rotateq was the first rotavirus vaccine to come onto the market (2006). I provided full details on how this vaccine is made in The Vaccine Book. Now there is a competitor, Rotarix (GlaxoSmithKline), licensed in April 2008. At the time The Vaccine Book was written I wasn’t able to provide you with the precise details on how its manufacturing process may differ from Rotateq. Here’s how it is made:

The viruses used in this vaccine are a single strain that was originally taken from infected humans. They are grown in a culture of monkey kidney cells to allow the virus to multiply. Batches of the virus are removed from the kidney cells and mixed into a solution of amino acids, sugars, and minerals (see details in The Vaccine Book).

As for the ingredients, I provided most of these in The Vaccine Book, except I couldn’t give details on what was in the solution that the viruses are grown in, called DMEM (Dulbecco’s Medium). DMEM contains numerous vitamins, minerals, sugars, amino acids, and phenol red.

Here is how the new Rotarix differs from the Rotateq:
Single strain of the virus (the most common one that infects humans), so it may be less protective against all strains of the virus compared to Rotateq (which uses 5 strains).
Virus comes from humans and is not “cross-bred”. The 5 strains in Rotateq are a mix of human and cow strains, and the viruses are cross bred to increase their effectiveness in the vaccine.
The PI for Rotarix makes no mention of using fetal cow serum to nourish the viruses as it does in Rotateq.
Rotarix only has TWO DOSES, compared to the three doses of Rotateq.

So, which one is better?

I have no preference between the two brands right now. I’ve been using the 3-dose Rotateq, since that’s what came out first. Once Rotarix has been out for a year or more, and no problems are found with it, I may switch over since it’s only two doses.

The timing of when you can give Rotavirus vaccine has expanded.

When Rotateq first came out, it was advised to be given around 2, 4, and 6 months. It could be started are early as 6 weeks, but the first dose needed to be started by 12 weeks of age. The last dose couldn’t be given later than 32 weeks of age.

NOW, you can start the vaccine at the slightly older age of 14 weeks and 6 days. And the last dose needs to be completed by 8 months, 0 days. These guidelines apply to both the 2-dose and the 3-dose brands. You are NOT supposed to go back and forth between the two brands.

Labels: Vaccines and their diseases

14 Comments:

At October 7, 2008 6:36 PM , Hilarie HIldebrand said...

Hi Dr. Bob!

I was wondering why this vaccine must be given so early. Is this because an older child wouldn't really need the protection that the vaccine gives, unless they are immune compromised?

We have a ten month old and haven't given him any vaccines yet, since we missed the mark on the only vaccination we ever seriously considered (pertusis). Is this a vaccination you recommend at an older age in an otherwise healthy infant?

Thanks for all of your research and for sharing your information!

-Hillary Hildebrand
(Our son is a patient of yours, but we haven't needed to see you again since his 1 month well-baby, *knock on wood*)
At October 8, 2008 6:56 PM , Dr. Bob said...

no, we can't give Rota starting at such a later age. Older kids COULD benefit from this protection, BUT it wasn't tested in older infants.
At October 11, 2008 8:15 PM , Julie said...

Hi Dr. Bob, I am kicking myself in the butt for passing over this info in your Vaccine Book. My son is 14 months, and I want to start the DTaP, HIB, Rota and PC since he is starting to interact with other kids. Any Rota options for ANY other age, adults included?
And, I just have to say thank you for all the info you compiled on vaccines. You have helped me and my family more than you will ever know.
Julie in NorCal
At October 13, 2008 2:15 PM , Dr. Bob said...

No, there's no way to vax against Rota for older kids. Good news is that it's rarely serious at this older age anyway.
At October 20, 2008 11:33 AM , Jennifer said...

I noticed that you said that the initial dose of Rotavirus was extended to 14 weeks 6 days and that the third dose can be given no later than 8 months 0 days. My doctor also told me that today. Yet I noticed that the Merck website still states that it needs to be given before 12 weeks. My doctor gave my son the first dose at 15 weeks 1 day, which is two days later than what it is suppose to be. Do you think that my son will still be protected from the Rotavirus and would you recommend completing the series of shots?

Thank you for all of your help. I appreciate your book and am grateful that there is another alternative to either following the "normal" schedule or not doing vaccines at all. We love "Dr. Bob's schedule" and that is what it is referred to at our doctor's office.

Thanks!
Jennifer
At October 22, 2008 7:23 PM , Jennifer said...

I have another question regarding the Rotateq...what if I didn't get the third dose? How would that affect my son, besides for not being fully immunized?
At October 27, 2008 11:36 AM , Chris said...

Hi Dr Bob -

Thank you for your time and help and patience with this long post.

I have a daughter that was born 5 weeks premature. She is currently 12 weeks old. She was jaundiced for weeks after birth. We are from the States, but in Montreal having serial casting and surgery for a club foot at Shriner's Hospital. Her surgeon recommended waiting until a few weeks after surgery for a first shot to allow her system to heal from the anesthesia. Here in Canada, they give first shot starting at 2 mos. I am told it's called Pediacell and it's a combo DTap, Hib and Polio. link www.phac-aspc.gc.ca/publicat/ccdr-rmtc/07vol33/acs-01/index_e.html We will be here having treatment for an indeterminate period of time. What are the risks of giving this shot to a preemie? How long will she be considered preemie as it relates to aluminum etc in vaccinations? I would be willing to drive over the border if you recommend finding a Pediatrician in the states who can/will split the vaccines. I want her immunized, but in as safe a way as possible. I have an older child who reacted to his first multi shot visit with a very high prolonged fever and would like to avoid this if possible.
At October 27, 2008 11:38 AM , Chris said...

Sorry, I just posted about a combo vaccine and my preemie - I forgot my original question about Rotateq. It doesn't seem to be offered here. Is it also something that is important that I "jump the border" to get at a clinic? Thanks for your help!
At December 31, 2008 8:10 AM , elizabeth said...

Dr. sears, my child is 14 weeks old with omphalocele surgery at 5 days old and tetralogy repair 7 weeks ago. she weighs 7 pounds and it is time for the rotavirus vaccine. should she get it with risks of intussesception? she is stay at home , not around children , and formula fed.
At March 14, 2009 2:06 AM , Amaya Lambert said...

Hello Dr. Bob, If I understood your book correctly, live virus vaccines can spread the disease to unvaccinated persons. My 4 mo old daughter had the RotaTeq brand vaccination for rotavirus on Monday. Today my nanny (who's from Brazil and has not necessarily had everything on the US vaccination schedule) shared that she's sick with vomitting, diarrhea, headache, etc. On Monday I reminded her to be cautious with washing her hands after diapering, but I'm not sure she consistently headed my advice. The nurse at my pediatrician's office said that it's impossible for Ava to have given her the virus unless she's immune-compromised. I am mostly concerned that she seek appropriate treatment if this virus is more serious than a 24-hr stomach bug. She sid she feels weak and hasn't felt like eating or drinking. I told her fluids, fluids, fluids. Boy is this the time in which I wish I knew Portugese! Thanks. Concerned Mommy,Amaya
At March 16, 2009 9:08 AM , Tiffany said...

Why do i doubt myself allthe time for giving the 1st dose of Rotateq!!! I'm in Canada a so far no on i know that there pediatricien gave it to the baby!!! An no one seems to know about it !!!
At April 23, 2009 8:24 AM , Anonymous said...

Hello Dr. Sears,
My child was born in 34th week and is today 23weeks old, we live in germany and here rotavirus vaccination is not in the usual vaccination list for infants thus we found out about it recently and got it done for my kid in her 22nd week. After reading ur anaylsis above i am a bit confused as to whether this vaccination would work for my kid at all or not as she got it much later than recommended. Please advice.
At August 23, 2009 1:18 PM , Anonymous said...

My daughter is 7 weeks and 5 days old. She is scheduled for her 2 month well baby visit and vaccines in 2 days. I am planning on following your alternate vaccine schedule. Since she would be getting the rotavirus vaccine if we were to follow that schedule in a couple of days, I was wondering if you have changed the schedule since the new information stating that the vaccine can be given at 14 weeks instead. I'd love to know if you have changed anything since I just bought your book when she was born. It is a decision that needs to be made soon. I'd love your input!
At August 25, 2009 5:59 PM , Anonymous said...

Hi Dr. Bob,
I have a question about the Rotavirus vaccine I was hoping to get a response from you. Have you changed your time line as to when it should be administered now that it can be given starting later? If I am choosing to follow the Selective vaccine schedule, when would you give it?

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