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Resolution No. 06/08-1 

ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES 

VACCINES FOR CHILDREN PROGRAM 

VACCINES TO PREVENT ROTAVIRUS GASTROENTERITIS

The purpose of this resolution is to add a newly licensed rotavirus vaccine to the Vaccines for 

Children Program. 

VFC resolution 2/06-2 is repealed and replaced by the following: 

Eligible Groups

Infants aged 6 weeks to 8 months 

Recommended Schedule for Rotavirus Vaccines 

 Rotateq ® Rotarix ® 

Dose Age Age

Primary 1 2 months 2 months

Primary 2 4 months 4 months

Primary 3 6 months -----------

Dosage Intervals and Ages for Rotavirus Vaccines 

RV5 (Rotateq®; Merck) RV1 (Rotarix®; GSK)*

Number of doses in series 3 2

Recommended ages for doses 2, 4, and 6 months 2 and 4 months

Minimum age for first dose 6 weeks

Maximum age for first dose 14 weeks 6 days

Interval between doses 4 weeks or more

Maximum age for last dose 8 months 0 days

Note: The use of brand names is not meant to preclude the use of other comparable licensed 

vaccines.

*Updated 11/29/2022 to include a new, oral dosing applicator only presentation of Rotarix 

licensed on 11/4/2022. 

Recommended Dosages 

Refer to product package inserts.
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Contraindications and Precautions1

The following conditions are contraindications to administration of rotavirus vaccine: 

a. Serious Allergic Reaction to Vaccine Components 

Severe allergic reaction (e.g., anaphylaxis) after a previous dose of rotavirus vaccine or to a 

vaccine component. Latex rubber is contained in the Rotarix® oral applicator, so infants with a 

severe (anaphylactic) allergy to latex should not receive Rotarix®. The Rotateq® dosing tube 

is latex-free.

b. Severe combined immunodeficiency (SCID) 

c. History of intussusception 

The following are precautions to administration of rotavirus vaccine: 

a. Altered Immunocompetence 

Practitioners should consider the potential risks and benefits of administering rotavirus vaccine 

to infants with known or suspected altered immunocompetence; consultation with an 

immunologist or infectious diseases specialist is advised. Children and adults who are 

immunocompromised because of congenital immunodeficiency, hematopoetic transplantation, 

or solid organ transplantation sometimes experience severe, prolonged and even fatal rotavirus 

gastroenteritis. However, no safety or efficacy data are available for the administration of 

rotavirus vaccine to infants who are potentially immunocompromised, including 

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Infants with primary and acquired immunodeficiency states, including cellular 

immunodeficiencies; and hypogammaglobulinemic and dysgammaglobulinemic states. 

Infants with blood dyscrasias, leukemia, lymphomas of any type, or other malignant 

neoplasms affecting the bone marrow or lymphatic system 

Infants on immunosuppressive therapy (including high dose systemic corticosteroids); 

Infants who are HIV-exposed or infected. However, the following considerations 

support vaccination of HIV-exposed or infected infants: 

the HIV diagnosis may not be established in infants born to HIVinfected mothers before the age of the first rotavirus vaccine dose; only 

1.5%-3% of HIV-exposed infants in the US will be determined to be 

HIV-infected, and 

Vaccine strains of rotavirus are considerably attenuated 

b. Acute Gastroenteritis 

In usual circumstances, rotavirus vaccine should not be administered to infants with acute, 

moderate to severe gastroenteritis until the condition improves. However, infants with mild 

acute gastroenteritis can be vaccinated, particularly if the delay in vaccination might be 

substantial and might make the child ineligible to receive vaccine (e.g., aged ≥15 weeks 0 days 

before the vaccine series is started). Rotavirus vaccine has not been studied among infants with 

concurrent acute gastroenteritis. In these infants, the immunogenicity and efficacy of rotavirus 

vaccine can theoretically be compromised. For example, infants who receive oral poliovirus 

vaccine (OPV) during an episode of acute gastroenteritis in some circumstances have 

diminished poliovirus antibody responses. 
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c. Moderate to Severe Illness 

As with all other vaccines, the presence of a moderate or severe acute illness with or without 

fever is a precaution to administration of rotavirus vaccine. Infants with a moderate to severe 

acute illness should be vaccinated as soon as they have recovered from the acute phase of the 

illness. This precaution avoids superimposing any potential adverse effects of the vaccine on 

the underlying illness or mistakenly attributing a manifestation of the underlying illness to the 

vaccine. Vaccination should not be delayed because of the presence of mild respiratory tract 

illness or other mild acute illness with or without fever. 

d. Preexisting Chronic Gastrointestinal Disease 

Infants with preexisting gastrointestinal conditions (e.g., congenital malabsorption syndromes, 

Hirschsprung’s disease, short-gut syndrome) who are not undergoing immunosuppressive 

therapy should benefit from rotavirus vaccine vaccination, and ACIP considers the benefits to 

outweigh the theoretical risks. However, no data are available on the safety and efficacy of 

rotavirus vaccine for infants with preexisting chronic gastrointestinal disease. 

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Contraindications and Precautions updated on 2/10/2023 to align with the CDC Child and 

Adolescent Immunization Schedule and current ACIP recommendations.

Adopted and Effective: June 25, 2008 

This document can be found on the CDC website at: 

https://www.cdc.gov/vaccines/programs/vfc/providers/resolutions.html