Guidance

Protecting your baby against rotavirus

Updated 1 June 2022

Since 1 July 2013, the routine childhood immunisation schedule has included a vaccine to protect babies against rotavirus infection – a common cause of diarrhoea and sickness that can become very serious.

This guidance describes what rotavirus is, which babies are eligible for the vaccination and explains when and how your baby will receive the vaccine.

Rotavirus

Most babies have vomiting or diarrhoea at some time, and parents deal with this routinely.

Many of these illnesses are caused by a virus called rotavirus. Most babies recover at home but, in a small number of cases, rotavirus infection can become serious, with babies getting dehydrated (losing body fluids) and possibly needing hospital treatment.

In England, almost all children will get rotavirus within the first 5 years of life.

Before the introduction of the vaccine in July 2013, around half of all gastroenteritis in children under 5 years old was caused by rotavirus and in England and Wales, about 1 out of 10 of those children (roughly 13,000 a year) were admitted to hospital.

How rotavirus is spread

Rotavirus can spread very easily and, once infected, babies can pass it on to others.

The virus can be spread through hand to mouth contact and can be picked up from contaminated surfaces such as toys, hands or dirty nappies. It can also be spread through the air by sneezing and coughing.

Washing hands and keeping surfaces clean can help reduce the spread of the virus but can never completely stop it.

Evidence shows that the most effective way to prevent babies catching rotavirus is to give them the rotavirus vaccination.

Timing of rotavirus vaccination

Two doses of the vaccine will be given with your baby’s other routine vaccinations. The first dose is given at 8 weeks of age and the second dose at 12 weeks. The 2 doses need to be given at least 4 weeks apart to get the best protection.

If your baby misses the first dose, they can have it up to 15 weeks old. If they miss the second dose, they can have it up to 24 weeks old.

Why older babies can’t have the vaccine

As they get older, some babies – about 1 out of 1,000 – get a condition that causes a blockage in their lower gut.

It is extremely rare before 3 months of age and most cases occur between 5 months and a year. In addition, there is a very small chance (between 1 and 6 additional cases in every 100,000 babies vaccinated) that the first dose of the vaccine might also cause this blockage to develop.

To reduce the risk of this happening, the first dose of the vaccine will not be given to babies older than 15 weeks and the vaccine will not be given to any babies older than 24 weeks of age.

Many unvaccinated babies over 24 weeks will already have had rotavirus infection and built up some immunity to it. This means that any future infections will be less severe. And, if younger babies are having the vaccination, the chances of rotavirus spreading will be reduced.

How the vaccine is given

Rotavirus vaccine is given as a liquid from a dropper to make it easy for your baby to swallow.

If your baby vomits immediately after having the vaccine

The drops can be given again at the same appointment.

Will your baby get the rotavirus disease from having the vaccine?

The vaccine is a live vaccine and works by mimicking natural infection. As the viruses in the vaccine are weakened, they don’t cause severe disease but between 1 and 10 infants in every 100 vaccinated can experience mild diarrhoea for a short time after vaccination. By having the vaccine, your baby will build up immunity so the next time they come into contact with the virus they will not get the disease.

Because the vaccine is given by mouth, it’s possible that the virus in the vaccine will pass through your baby’s gut and be picked up by whoever changes his or her nappy.

All those in close contact with recently vaccinated babies should observe good personal hygiene and remember to wash their hands after changing the baby’s nappy.

Side effects

Many millions of doses of the vaccine have been used and it has a good safety record. Babies who have had the vaccine can sometimes become restless and irritable, and some may develop mild diarrhoea. If you’re at all concerned about your baby’s health a day or so after any vaccination you should speak to your doctor or health visitor.

In very rare cases (between 1 and 6 in every 100,000 babies vaccinated), the vaccine can affect the baby’s lower gut and they may develop abdominal pain, vomiting, and sometimes they may pass what looks like redcurrant jelly in their nappies. If this happens, you should contact your doctor immediately.

If your baby is ill on the day the vaccination is due

There is no reason to postpone the appointment unless your baby is vomiting, has diarrhoea, is seriously ill or has a fever.

If your baby is well enough to have the other routine vaccines, he or she can have the rotavirus vaccine.

Babies who shouldn’t have the vaccination

The first vaccination should not be given after 15 weeks of age and no vaccination should be given after 24 weeks.

The vaccination should not be given to babies who:

• have mothers who had treatment that affected her immune system while she was pregnant or breastfeeding
• are diagnosed with Severe Combined Immunodeficiency (SCID), a rare genetic disease that makes babies very vulnerable to infection
• have reacted very badly to a previous dose of the vaccine, or to any of the ingredients that go into the vaccine
• have certain long-term conditions – in which case, speak to your GP first
• have a fever, diarrhoea or are vomiting on the day of the appointment – in which case, the visit should be rearranged

When should premature babies have the vaccination

As with all vaccinations, the immunisation schedule should be followed from the actual date of birth, not from the date when the baby was due.

Breastfeeding your baby after they have the vaccination

There are no problems associated with breastfeeding babies who have recently had the rotavirus vaccine.

Will the vaccine stop babies getting any sickness and diarrhoea?

No. Rotavirus isn’t the only cause of sickness and diarrhoea in babies. However, the vaccine will stop about 8 out of 10 babies getting vomiting and diarrhoea caused by rotavirus. And the more babies that have the vaccine, the more difficult it will be for the virus to spread.

Rotavirus vaccination summary

Infection with rotavirus causes sickness and diarrhoea in young babies.

It can lead to hospitalisation.

The vaccine is given as drops in the mouth at 8 and 12 weeks of age.

It will help prevent 8 out of 10 cases of rotavirus infection.

Babies over 24 weeks of age will not be given the vaccine.

Further information

Talk to your GP, health visitor or practice nurse for further information.

See rotavirus vaccine on NHS.UK.