Vaccination against the rotavirus

definition

The rotavirus is widespread worldwide and is the most common cause of inflammation of the gastrointestinal tract in children. Due to the high contagion potential and the long survival time of the virus, for example on toys or door handles, almost all children fall ill up to the age of 5.
The rotavirus is the main cause of the high infant mortality rates in developing countries.
In western countries mortality from rotavirus is extremely low, but infection is associated with severe symptoms such as fever, gushing vomiting and severe diarrhea.

The virus is transmitted via so-called smear infections, which means that it is transmitted via the stool and hands of the infected person, with the smallest amounts of virus particles (approx. 15) being sufficient to trigger an infection (for comparison, the infection dose is the known Salmonella enteritidis virus between 100,000 and 100,000,000 virus particles).
The rotavirus oral vaccination has been included in the vaccination recommendation of the STIKO (Standing Vaccination Commission) since 2013.

Should I have my child vaccinated?

More information can be found here: Should I get my baby vaccinated?

Facts

Around 2,000 out of 100,000 small children under 2 years of age develop rotavirus infections every year.
Around half of them have to be admitted to hospital as part of this disease, of which around 50 children have to be treated in the intensive care unit.
Every year a child in Germany dies of a rotavirus infection.
At the end of the 20th century there was already a rotavirus vaccination. However, this vaccine was used because of the increased incidence of Intestinal invaginations, in which one part of the intestine is turned over the other, taken off the market.
With the vaccine approved today, no increased risk of intussusception was found after the approval study in over 130,000 children; later studies in the USA and Australia found a slightly increased risk (approx. 1-2 intussusception per 100,000 children).

advantages

In Germany, the risk for an unvaccinated toddler to develop an invasions of the intestine is 0.06%; according to the current study, it is 0.061% for vaccinated children, which means that by Vaccination 1 in 100,000 (= 0.001%) children suffer more from intussusception than without the vaccination.
The STIKO and most of the doctors allowed the STIKO to weigh up the slightly increased risk of invasions of the intestine due to the vaccination (0.001%) and the relatively high risk of intensive medical treatment in the event of infection (50 of 100,000 children (= 0.05%)) come to the conclusion in Germany that vaccination also makes sense in the western world.
There are also so far in Germany no documented death after vaccination related intestinal invagination.
Since the pathogen is excreted in the stool of the infected person for about 14 days and only a few germ particles are required for an infection, a vaccination not only protects your own child, but, as with all vaccinations, also the children around their child.
Since there are many different strains of the virus, i.e. several subgroups of the same pathogen, the one-time illness from a rotavirus infection does not protect against further infections with other strains.

A vaccination covers, among other things, the virus strains that are responsible for 80% of infections (serotypes G1,2,3 and 4). Thus, an infection is prevented by over 90% vaccine is not fatal, the requirements for the vaccine in terms of side effects and tolerability are enormous. Diarrhea, vomiting, fever and the rare Kawasaki syndrome were initially associated with vaccination, which increases these symptoms compared to unvaccinated peers However, studies have not been able to confirm the occurrence. Another advantage of vaccination is the method of administration. The rotavirus vaccination is an oral vaccination in which the child does not have to be confronted with needles.

disadvantage

It is about a Live vaccination, that is, the pathogen is modified so that it cannot trigger the disease in the child's body, and then brought into contact with the child's immune system.With other vaccinations, such as the meningococcal vaccination or the rabies vaccination, only virus components are administered, this is then called dead vaccination.
Live vaccines come with a stronger immune response (e.g. fever).
Also are two visits to the doctor needed to get the vaccination.

Another point of criticism is the economic damage caused by vaccination. So far, 50 million euros have been invested annually in the treatment of rotavirus infections, and the annual costs for vaccination are 100 million euros.

You may also be interested in the following article: Vaccination - Does vaccination do more harm than good?

How does the vaccination work and can you still get infected afterwards?

The immunization through the vaccination should start in the 6th week and be completed by the 24th or 32nd week of life, depending on which of the two vaccines available in Germany one has chosen.
Two single doses are given to the child orally (by mouth). These single doses should be given every two weeks and can be given with other vaccines.

During vaccination, the modified viruses are absorbed through the gastrointestinal mucosa and the immune system forms antibodies against the virus. The cells (B lymphocytes) that are "imprinted" on these viruses (that is, which form antibodies specially tailored to these viruses) can be reactivated again and again by the body when the child comes into contact with the virus. Upon contact, the viruses are then eliminated on the spot without being able to trigger the disease. Since there are many subtypes of rotavirus, it is It is also possible after vaccination to become infected with a rotavirus strain not included in the vaccination. The likelihood of vaccinated children developing diarrhea drops by 41% in the first year after vaccination. This applies both to rotavirus infections and to diarrhea caused by other pathogens. The chance of contracting rotavirus drops by 90% in the first year after vaccination.

Read about the topic: Homeopathy for vaccination

What kind of vaccine is used and how expensive is it?

Two vaccines have been used in Germany since 2006, on the one hand RotaTeq® (Sanofi) on the other hand Rotarix® (GlaxoSmithKline).

RotaTeq® contains the strains G1,2,3,4 and 9 and is sold ready-to-use in a 2ml dose. Vaccination should start in the 6th week and be completed by the age of 32 weeks. Rotarix® covers the seeds G1 (100% immunity) G2,3 and 9 (75% immunity) and is sold as a powder that is then mixed with a liquid and taken orally. The vaccination should be as with RotaTeq in the 6th week started, but in this case ended up to the 24th week of life. Both vaccinations cost around 135 euros and are covered by your statutory health insurance. For privately insured persons, it depends on the tariff chosen by.

What should I watch out for after vaccination? Can I breastfeed my child?

You should have made an appointment with your pediatrician for the second dose by the day of the first dose of your child's vaccination at the latest.
Also, despite the rarity of the complication, it is advisable to check out the Early signs of intestinal invaginations to be aware.
These consist of strong, suddenly onset abdominal pain, in which the child classically screams shrilly and keeps the legs drawn in a protective position. Further symptoms are bloody diarrhea, recurrent vomiting and, in very severe cases, signs of dehydration.
The symptoms do not have to appear in the form mentioned and if you are unsure it is advisable to contact your pediatrician.
The fact that your child reacts with signs of an immune reaction such as a slight fever, diarrhea or vomiting can also occur in the normal course of the vaccination and is a sign that the vaccination has worked.
Many parents wonder whether they can breastfeed their child during the vaccination phase.
Studies have shown that immune substances such as lactoferrin in breast milk can weaken the vaccination if breastfeeding is carried out in a short time in relation to the administration of the dose.
For this reason it is recommended not breastfeeding about an hour before and after vaccination.
Outside of this period, you can breastfeed your child without reducing the vaccination response.

This article might also interest you: Fever after vaccination in the baby

Side effects of vaccination

Common side effects of vaccination are loss of appetite, vomiting, fever and diarrhea.

These side effects occur in 1 in 200 children who are vaccinated.
Occasionally, abdominal pain, gas, and cold symptoms occur.
Rare side effects are rashes and blood in the stool.
Especially in children with a tendency to invasions of the intestines, so-called Intussusception come, in Germany, according to STIKO, vaccination increases the probability of intussusception by 0.001%.

You can find more information here: Side effects of vaccinations in babies

Diarrhea is one of the side effects of vaccinations in babies. Read our main article about this: Diarrhea After Vaccination In Baby - Is It Dangerous?

Should I get vaccinated as an adult?

Vaccination in adulthood is not necessary, since the probability that you have been infected several times with the most common strains of pathogens and have built up your own immunity is almost 100%.
In addition, the infection with rotaviruses in adults is not as severe as in small children.
Admission in Germany is limited from the 6th to the 24th / 32nd. Week of life.

Please also read our topic: Vaccinations for adults