Delayed Rotavirus?

[veganone]

Does anyone know why rotavirus vax isn't supposed to be started after 12 weeks? DD is 16 weeks and I am planning to begin selective vaxes at her next WB appt. She will be in daycare at some point, but we are waiting to get in and will be cared for by my parents at home when I go back to work after New Year's.

With her entering daycare at some point, I do think the rotavirus vax is worth considering, but it sounds like we're too late to get it at all???

Also, DD has had ongoing digestive issues (I'm on an elimination diet to try to alleviate them) and don't want to give her a live-virus intestinal vaccine while her system is already whacked...

[amnesiac]

The ages have to do with how clinical trials were conducted - it will only be licensed according to how it was studied. Although it says children over 12 weeks of age shouldn't begin the series there are pediatricians who still do it off label.

http://www.cdc.gov/mmwR/preview/mmwrhtml/rr5512a1.htm

[cloak]

Originally Posted by veganone

Does anyone know why rotavirus vax isn't supposed to be started after 12 weeks?

It is delayed because intussusception is a known complication of the vaccine. Intussusception is most common in babies older than 12 weeks (would have to look up the exact age). They do not want to give the vaccine at the normal high risk time for babies because then it would be hard to tell if the vaccine was at fault or not.

[amnesiac]

I wanted to add this from the manufacturer:

No safety or efficacy data are available for the administration of RotaTeq to infants who are potentially immunocompromised, or with a history of gastrointestinal disorders.

http://www.rotateq.com/

And to clarify that intussusception was a known complication of a previous vaccine which was recalled from the market, not the one being used currently. And the risk for that complication did increase with age at the time of first dose receipt. The reason it isn't licensed for use in babies over 12 weeks is because Merck didn't study initiation of the series beyond that age not because it was documented to be a problem with this vaccine as well. But I'm sure that played a role in the determination of clinical trial structure for the new product - I mean who would really want to go there, right?

http://www.journals.uchicago.edu/doi/pdf/10.1086/431512