The Basics
What is Rotavirus Vaccines?
Vaccine used to protect against rotavirus infections.
Brand names for Rotavirus Vaccines
Rotarix
How Rotavirus Vaccines is classified
Vaccines, Viral Vaccines
Rotavirus Vaccines During Pregnancy
Rotavirus Vaccines pregnancy category
Category CNote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.
What we know about taking Rotavirus Vaccines while pregnant
Animal reproduction studies have not been conducted with ROTARIX. It is also not known whether ROTARIX can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity.
Taking Rotavirus Vaccines While Breastfeeding
What are recommendations for lactation if you're taking Rotavirus Vaccines?
Rotavirus vaccines are used only in infants and are not indicated for use in women of childbearing age. Breastfeeding protects infants against acute gastroenteritis caused by rotavirus.[1][2] However, breastfeeding can reduce the immune response of an infant to rotavirus vaccines in developing countries.[3][4][5][6][7] Lactadherin, a milk glycoprotein, may be a cause.[8] Breastfeeding might also reduce viral shedding in the stool by the vaccinated infants.[6] The extent of the effect depends on the maternal anti-rotavirus antibody titer in breastmilk with higher titers found in less developed areas.[9][10][11][12] Withholding breastfeeding for up to 2 hours before and after vaccine administration has been recommended to minimize the interference.[9][13] However, some studies found that withholding breastfeeding for either one hour before and after immunization,[14][15] or for 30 minutes before vaccination had no effect on seroconversion.[16] A review concluded that withholding of breastfeeding at the time of vaccination had no effect on seroconversion of infants.[17] A European study found no difference in rotavirus infection rates during the first season between infants who were breastfed and formula-fed when they received rotavirus vaccination. In the second season, protection against infection was slightly less in breastfed infants.[4] A German study found that exclusive or partial breastfeeding increased the risk of breakthrough infection fourfold.[5] A study in Indonesia found that rotavirus vaccine was cost-effective for the health system, even with improved breastfeeding rates.[18]
Maternal / infant drug levels
Rotavirus vaccines are used only in infants and are not indicated for use in women of childbearing age. Breastfeeding protects infants against acute gastroenteritis caused by rotavirus.[1][2] However, breastfeeding can reduce the immune response of an infant to rotavirus vaccines in developing countries.[3][4][5][6][7] Lactadherin, a milk glycoprotein, may be a cause.[8] Breastfeeding might also reduce viral shedding in the stool by the vaccinated infants.[6] The extent of the effect depends on the maternal anti-rotavirus antibody titer in breastmilk with higher titers found in less developed areas.[9][10][11][12] Withholding breastfeeding for up to 2 hours before and after vaccine administration has been recommended to minimize the interference.[9][13] However, some studies found that withholding breastfeeding for either one hour before and after immunization,[14][15] or for 30 minutes before vaccination had no effect on seroconversion.[16] A review concluded that withholding of breastfeeding at the time of vaccination had no effect on seroconversion of infants.[17] A European study found no difference in rotavirus infection rates during the first season between infants who were breastfed and formula-fed when they received rotavirus vaccination. In the second season, protection against infection was slightly less in breastfed infants.[4] A German study found that exclusive or partial breastfeeding increased the risk of breakthrough infection fourfold.[5] A study in Indonesia found that rotavirus vaccine was cost-effective for the health system, even with improved breastfeeding rates.[18]
Possible effects of Rotavirus Vaccines on milk supply
Relevant published information was not found as of the revision date.
Possible alternatives to Rotavirus Vaccines
None listed
List of References
Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Plenge-Bonig A, Soto-Ramirez N, Karmaus W et al. Breastfeeding protects against acute gastroenteritis due to rotavirus in infants. Eur J Pediatr. 2010;169:1471-6. PMID: 20617343
2. Das S, Sahoo GC, Das P et al. Evaluating the impact of breastfeeding on rotavirus antigenemia and disease severity in Indian children. PLoS One. 2016;11:e0146243. PMID: 26828823
3. Goveia MG, Dinubile MJ, Dallas MJ, Heaton PM, Kuter BJ. Efficacy of pentavalent human-bovine (WC3) reassortant rotavirus vaccine based on breastfeeding frequency. Pediatr Infect Dis J. 2008;27:656-8. PMID: 18520448
4. Vesikari T, Prymula R, Schuster V et al. Efficacy and immunogenicity of live-attenuated human rotavirus vaccine in breast-fed and formula-fed European infants. Pediatr Infect Dis J. 2012;31:509-13. PMID: 22228235
5. Adlhoch C, Hoehne M, Littmann M et al. Rotavirus vaccine effectiveness and case-control study on risk factors for breakthrough infections in Germany, 2010-2011. Pediatr Infect Dis J. 2013;32:e82-9. PMID: 23334342
6. Bautista-Marquez A, Velasquez DE, Esparza-Aguilar M et al. Breastfeeding linked to the reduction of both rotavirus shedding and IgA levels after Rotarix(R) immunization in Mexican infants. Vaccine. 2016;34:5284-9. PMID: 27663670
7. Parker EP, Ramani S, Lopman BA et al. Causes of impaired oral vaccine efficacy in developing countries. Future Microbiol. 2018;13:97-118. PMID: 29218997
8. Mwila-Kazimbaya K, Garcia MP, Bosomprah S et al. Effect of innate antiviral glycoproteins in breast milk on seroconversion to rotavirus vaccine (Rotarix) in children in Lusaka, Zambia . PLoS One. 2017;12:e0189351. PMID: 29284036
9. Moon SS, Wang Y, Shane AL et al. Inhibitory effect of breast milk on infectivity of live oral rotavirus vaccines. Pediatr Infect Dis J. 2010;29:919-23. PMID: 20442687
10. Chan J, Nirwati H, Triasih R et al. Maternal antibodies to rotavirus: Could they interfere with live rotavirus vaccines in developing countries? Vaccine. 2011;29:1242-7. PMID: 21147127
11. Moon SS, Groome MJ, Velasquez DE et al. Prevaccination rotavirus serum IgG and IgA are associated with lower immunogenicity of live, oral human rotavirus vaccine in South African infants. Clin Infect Dis. 2016;62:157-65. PMID: 26400993
12. Trang NV, Braeckman T, Lernout T et al. Prevalence of rotavirus antibodies in breast milk and inhibitory effects to rotavirus vaccines. Hum Vaccin Immunother. 2014;10:3681-7. PMID: 25668672
13. Foster RH, Wagstaff AJ. Tetravalent human-rhesus reassortant rotavirus vaccine: a review of its immunogenicity, tolerability and protective efficacy against paediatric rotavirus gastroenteritis. BioDrugs. 1998;9:155-78. PMID: 18020551
14. Groome MJ, Moon SS, Velasquez D et al. Effect of breastfeeding on immunogenicity of oral live-attenuated human rotavirus vaccine: a randomized trial in HIV-uninfected infants in Soweto, South Africa. Bull World Health Organ. 2014;92:238-45. PMID: 24700991
15. Ali A, Kazi AM, Cortese MM et al. Impact of withholding breastfeeding at the time of vaccination on the immunogenicity of oral rotavirus vaccine-a randomized trial. PLoS One. 2015;10:e0127622. PMID: 26035743
16. Rongsen-Chandola T, Strand TA, Goyal N et al. Effect of withholding breastfeeding on the immune response to a live oral rotavirus vaccine in North Indian infants. Vaccine. 2014;32 (Suppl 1):A134-A139. PMID: 25091668
17. Mwila K, Chilengi R, Simuyandi M et al. Contribution of maternal immunity to decreased rotavirus vaccine performance in low and middle income countries. Clin Vaccine Immunol. 2017;24:e00405-16. PMID: 27847365
18. Suwantika AA, Postma MJ. Effect of breastfeeding promotion interventions on cost-effectiveness of rotavirus immunization in Indonesia. BMC Public Health. 2013;13:1106. PMID: 24289227
19. Becker-Dreps S, Vilchez S, Velasquez D et al. Rotavirus-specific IgG antibodies from mothers’ serum may inhibit infant immune responses to the pentavalent rotavirus vaccine. Pediatr Infect Dis J. 2015;34:115-6. PMID: 25741808
Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.
