International travel and health



Two live, attenuated, oral rotavirus vaccines are internationally licensed and routine childhood vaccination has been initiated in a number of countries. The clinical efficacy of the rotavirus vaccines has been demonstrated in most parts of the world. WHO recommends the inclusion of rotavirus vaccination in all national immunization programmes, particularly in countries at high risk of severe disease and fatal outcomes.

Rotarix vaccine should be administered orally in a 2-dose schedule at the time of the first and second doses of DTP and with an interval of 4 weeks between the doses. RotaTeq requires an oral 3-dose schedule administered with DTP1, DTP2, and DTP3 and with an interval of 4-10 weeks between doses.

Although early immunization is favored, the previous age restrictions for the first and last dose of rotavirus vaccines prevented vaccination of many vulnerable children in settings where the DTP doses are given late (i.e. after 15 weeks for DTP1 or after 32 weeks for DTP 2 or DTP3). Therefore, the administration of the rotavirus vaccines should be given along the DTP contacts without a recommended age limit for first or the last dose.

Because most severe cases of rotavirus gastroenteritis occur earlier in life, vaccination of children older than 24 months is not encouraged.

Vaccine safety

Postmarketing surveillance of both currently available rotavirus vaccines has detected a small increased risk of intussusception (about 1–2/100 000 infants vaccinated) in some settings shortly after the first dose is administered. This risk is 5–10 times lower than that observed with the previously licensed vaccine, and the benefits of rotavirus vaccination against severe diarrhoea and death from rotavirus infection far exceed the risk of intussusception.