Time to Begin a New Chapter and Expand Rotavirus Immunization

Dramatic declines in rotavirus have occurred in vaccinated and unvaccinated persons (through indirect protection). Despite these declines, persons benefitting from indirect protection remain at risk of rotavirus. Expansion of the age of rotavirus vaccination outside current recommendations should be considered.

Rotavirus immunization has been limited to young infants owing to intussusception events noted with a prior rotavirus vaccine, RotaShield. Dramatic declines occurred in rotavirus-related disease beginning in 2008 after implementation of rotavirus vaccination in young infants. These declines occurred in vaccinated children and unvaccinated children and adults (through indirect protection). Despite these declines, reasons for concern exist about the durability of these declines. These reasons include an incomplete immune response that is not lifelong and rotavirus immunization completion rates that have plateaued at <70% of eligible children. Current rotavirus infant vaccination strategies and indirect protection of unvaccinated children will result in a large population of immunologically susceptible persons who will be at risk of rotavirus disease. Expansion of US rotavirus vaccination outside the current Advisory Committee on Immunization Practices recommended immunization age limits would provide important benefits that outweigh risk related to intussusception.

age, immunization, intussusception, rotavirus, vaccines