Professional edition active

Rotavirus Vaccine

ByMargot L. Savoy, MD, MPH, Lewis Katz School of Medicine at Temple University
Reviewed ByEva M. Vivian, PharmD, MS, PhD, University of Wisconsin School of Pharmacy
Reviewed/Revised Modified Jul 2025
v39242767
View Patient Education

The rotavirus vaccine is recommended for infants to protect against The rotavirus vaccine is recommended for infants to protect againstgastroenteritis caused by rotavirus disease.

(See also Overview of Immunization.)

Preparations of Rotavirus Vaccine

There are 2 rotavirus vaccines available for use in infants in the United States:

  • RV5

  • RV1

Rotavirus vaccines are live-virus vaccines that are also attenuated.

Indications for Rotavirus Vaccine

The rotavirus vaccine is a routine childhood vaccination (see The rotavirus vaccine is a routine childhood vaccination (seeCDC: Child and Adolescent Immunization Schedule by Age).

Contraindications and Precautions for Rotavirus Vaccine

Contraindications for rotavirus vaccines are the following:

The main precautions with rotavirus vaccines are the following:

  • Moderate or severe acute illness with or without fever, including moderate or severe diarrhea or vomiting (vaccination is postponed until the illness resolves; infants with mild illness can be given the vaccine)

  • Spina bifida or bladder exstrophy

  • Altered immunocompetence other than SCID (eg, infants with HIV infection)

  • Chronic gastrointestinal disease

(See also CDC: Contraindications and Precautions to Vaccination: Rotavirus Vaccine Contraindications and Precautions.)

The safety and efficacy of rotavirus vaccines have not be established in infants with the following:

  • Advanced HIV infection or any other disease that affects the immune system

  • Treatment with corticosteroids or other immunosuppressants

  • Cancer or cancer treatment with radiation or medications

Dose and Administration of Rotavirus Vaccine

Rotavirus vaccines are administered orally by putting drops in the infant's mouth. The dosing for the 2 vaccines is slightly different:

  • RV5 is administered orally in 3 doses, 1 dose at age 2 months, 4 months, and 6 months.

  • RV1 is administered orally in 2 doses, 1 dose at age 2 months and 4 months.

  • If any dose in the series is either RV5 or unknown, default to a 3-dose series.

If the first dose of rotavirus vaccine is inadvertently administered at age ≥ 15 weeks, the remaining doses should be administered at the routinely recommended intervals.If the first dose of rotavirus vaccine is inadvertently administered at age ≥ 15 weeks, the remaining doses should be administered at the routinely recommended intervals.

Rotavirus vaccine should not be administered after age 8 months 0 days, even if the series is incomplete because of the risk of intussusception.Rotavirus vaccine should not be administered after age 8 months 0 days, even if the series is incomplete because of the risk of intussusception.

Adverse Effects of Rotavirus Vaccine

Adverse effects are rare but include irritability, mild temporary diarrhea, and vomiting.

There is a very small risk of bowel intussusception with the rotavirus vaccine. Intussusception usually occurs within a week after the first or second dose. Surgery may be required.There is a very small risk of bowel intussusception with the rotavirus vaccine. Intussusception usually occurs within a week after the first or second dose. Surgery may be required.

For more information about adverse effects of these vaccines, refer to the prescribing information.

More Information

The following English-language resources may be useful. Please note that The Manual is not responsible for the content of these resources.

  1. Advisory Committee on Immunization Practices (ACIP): ACIP Recommendations: Rotavirus Vaccine

  2. ACIP: Changes in the 2025 Child and Adolescent Immunization Schedule

  3. Centers for Disease Control and Prevention (CDC): Rotavirus

  4. European Centre for Disease Prevention and Control (ECDC): Rotavirus Infection: Recommended vaccinations

Drugs Mentioned In This Article

quizzes_lightbulb_red
Test your KnowledgeTake a Quiz!
Download the free Merck Manual App iOS ANDROID
Download the free Merck Manual App iOS ANDROID
Download the free Merck Manual App iOS ANDROID