Your two month old recently got her vaccines, including the rotavirus vaccine.
Now you have diarrhea.
Was it from shedding from your child’s rotavirus vaccine?
Does the Rotavirus Vaccine Shed?
And like with most other vaccines, this shedding isn’t usually a cause for concern and definitely isn’t a reason to think about skipping or delaying your child’s vaccines.
“All members of the household should wash their hands after changing the diaper of an infant. This minimizes rotavirus transmission, for an undetermined number of weeks after vaccination, from an infant who received rotavirus vaccine.”
General Recommendations on Immunization Recommendations of the Advisory Committee on Immunization Practices (ACIP)
If you wash your hands when you change your child’s diapers after they have been vaccinated, just like you hopefully do anyway, you can avoid any possible contact with any rotavirus vaccine virus that might be shed in your child’s stool.
Can I Get Rotavirus from My Recently Vaccinated Baby?
But what would be the risk of your getting sick if you did come into contact with shedding rotavirus vaccine virus in your child’s diaper?
Would you be at risk to get sick?
Did your baby get sick after getting the actual vaccine?
That’s the thing about shedding that many people don’t understand. These live vaccines are made with attenuated or weakened strains of viruses, so they don’t typically get you sick when you are vaccinated. And they don’t typically get you sick when you are exposed through shedding. In fact, this shedding can sometimes help build herd immunity, as more people get exposed to the weakened strain of vaccine virus.
But can they get you sick?
Yes, if you have a problem with your immune system, which is why there are warnings about giving live vaccines to folks who are immunocompromised. And there used to be warnings about giving the oral polio vaccine to kids if they were around anyone with an immune system problem.
Vaccine viruses could also get you sick if they mutated from their attenuated state and became more virulent. Fortunately, that rarely happens with most vaccines.
“The theoretical risk of HRV and PRV shedding, transmission to, and infection of immunocompromised contacts is much lower than the real risk of wildtype rotavirus infection transmitted from unvaccinated children.”
Anderson on Rotavirus vaccines: viral shedding and risk of transmission
And most importantly, since kids are much more likely to shed virus after natural infections, it is much safer for everyone to get vaccinated and protected with these vaccines.
Surprisingly, even children with asymptomatic natural rotavirus infections can shed virus for several weeks, which is likely why these infections used to spread so easily or without known contacts.
Something that will likely surprise some folks even more is the news that just because someone gets diarrhea after being exposed to the rotavirus vaccine, either because they were vaccinated or through shedding, it doesn’t mean that the vaccine was the cause of the diarrhea!
“Of note, among all six AGE cases which possessed Rotarix-derived strains, four (sample No.1, 5, 6 and 7) were suspected to be caused by other pathogens. Most likely, the infants were infected with other pathogens during the shedding period of Rotarix strain.”
Kaneko et al on Identification of vaccine-derived rotavirus strains in children with acute gastroenteritis in Japan, 2012-2015
When vaccine strain rotavirus have been detected in kids with gastroenteritis, they often have other reasons to have diarrhea.
What does this all mean?
More on Shedding and Rotavirus Vaccines
- Ask the Experts about Rotavirus Vaccines
- General Recommendations on Immunization Recommendations of the Advisory Committee on Immunization Practices (ACIP)
- Study – Safety of Rotavirus Vaccine in the NICU
- Study – Rotavirus Vaccination Can Be Performed Without Viral Dissemination in the Neonatal Intensive Care Unit.
- Study – Rotavirus vaccines: viral shedding and risk of transmission.
- Study – Comparison of virus shedding after lived attenuated and pentavalent reassortant rotavirus vaccine.
- Study – Rotavirus shedding in symptomatic and asymptomatic children using reverse transcription-quantitative PCR.
- Study – Multivalent Rotavirus Vaccine and Wild-type Rotavirus Strain Shedding in Australian Infants: A Birth Cohort Study.
- Study – Identification of vaccine-derived rotavirus strains in children with acute gastroenteritis in Japan, 2012-2015.
- Study – Rotavirus vaccine virus shedding, viremia and clearance in infants with severe combined immune deficiency.
- Study – Identification of vaccine-derived rotavirus strains in children with acute gastroenteritis in Japan, 2012-2015
- Study – Identification of strains of RotaTeq rotavirus vaccine in infants with gastroenteritis following routine vaccination.
- Study – Symptomatic Infection and Detection of Vaccine and Vaccine-Reassortant Rotavirus Strains in 5 Children: A Case Series
- Rotavirus vaccine shedding poses little risk
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