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Pharmacology · Viral vaccines

Rotavirus vaccine !

Live oral vaccine that prevents severe rotavirus diarrhoea in infants. It carries a small risk of intussusception, so it has strict age limits.

Updated 2026-11-01

  • Class: Viral vaccines
  • Target: Rotavirus outer capsid protein VP7
  • ATC code: J07BH
  • WHO Model List of Essential Medicines

Also called: RV1 (monovalent human strain), RV5 (pentavalent human-bovine reassortant)

The figure shows the VP7 trimer bound to a neutralising antibody fragment; VP7 and VP4 define the serotypes and induce neutralising antibodies.

Target in 3D: Rotavirus outer capsid protein VP7. PDB structure 3FMG (RCSB PDB, public domain). View the structure at RCSB PDB

Mechanism of action

The vaccine virus replicates in the infant's gut and induces local and systemic immunity against the outer capsid proteins VP7 (G type) and VP4 (P type). The vaccine mainly prevents severe disease and dehydration rather than every infection. Vaccine virus is shed in the stool.

  1. Attenuated rotavirus is swallowed and replicates in the gut
  2. Antibodies form against VP7 and VP4
  3. Mucosal immunity limits the next natural infection
  4. Severe diarrhoea and dehydration are prevented

Pharmacokinetics

Absorption
Oral live vaccine that acts in the gut; the first dose has a strict maximum age

Indications

Adverse effects

Common

  • Irritability
  • Mild diarrhoea or vomiting

Contraindications

  • History of intussusception
  • Severe combined immunodeficiency (SCID)
  • Severe allergic reaction to a previous dose or a component; RV1 also with severe latex allergy (its applicator contains latex)

Key interactions

Immunosuppressed or pregnant household members
The infant can still be vaccinated; contacts avoid the infant's stool and wash hands after nappy changes

What is monitored

  • Signs of intussusception in the days after the dose (crying spells, vomiting, bloody stool)
  • Age of the infant at each dose

Administration and safety

  • Oral route only; never injected
  • Check the infant's age against the product's age limits before giving
  • Do not confuse the oral rotavirus applicator with oral polio drops
  • Record the batch and product

Nursing care

  • Ask about previous intussusception, SCID and latex allergy
  • Defer it during moderate or severe gastroenteritis
  • Teach the warning signs of intussusception: inconsolable crying, drawing up the legs, vomiting, blood in the stool
  • Teach hand washing after nappy changes

Pregnancy and breastfeeding

Not used in pregnancy (it is an infant vaccine); a pregnant mother in the home is not a reason to withhold it from the baby.

Test yourself

Think of the answer, then tap the question to see it.

Which serious adverse event is linked to rotavirus vaccine?

Intussusception, a small risk mainly in the first week after the first or second dose.

Which immunodeficiency contraindicates rotavirus vaccine?

Severe combined immunodeficiency (SCID): vaccine virus can cause severe infection.

Which two proteins define rotavirus serotypes?

VP7 (G protein) and VP4 (P protein) of the outer capsid.

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Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: Chapter 19: Rotavirus | Pink Book | CDC (Centers for Disease Control and Prevention, 2021); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.