Rotavirus Vaccine 

What is a rotavirus vaccine? 

Rotavirus is a highly contagious virus that primarily affects infants and young children, causing severe diarrhoea, vomiting, fever, and dehydration. It spreads easily through contact with contaminated hands, surfaces, and objects, which makes it a leading cause of hospitalisation for gastroenteritis worldwide. While good hygiene practices help reduce transmission, they are not enough to prevent infection entirely. The most effective way to protect against rotavirus is through vaccination.

The rotavirus vaccine is an oral immunisation designed to protect infants from the most common strains of the virus. Unlike injectable vaccines, it is administered as liquid drops into the baby’s mouth, which makes it a painless and convenient option for parents. The vaccine works by stimulating the body’s immune system to recognise and fight off rotavirus if exposed in the future. Studies have shown that the vaccine significantly reduces the risk of severe diarrhoea, hospitalisation, and complications associated with rotavirus infection.

In Singapore, the rotavirus vaccine is not part of the National Childhood Immunisation Schedule (NCIS), which means it is not government-funded or compulsory. However, the Ministry of Health (MOH) and paediatricians strongly recommend vaccination due to the high risk of severe rotavirus infection in young children.

The rotavirus vaccine is is typically administered in two or three doses, depending on the vaccine brand:

Rotarix® (two-dose schedule)	given at 2 months and 4 months of age.
RotaTeq® (three-dose schedule)	given at 2 months, 4 months, and 6 months of age.

Both vaccines provide strong protection against severe rotavirus disease, with effectiveness rates ranging between 85% and 98% in high-income countries and 50% to 70% in lower-income regions. Although the vaccine does not prevent all cases of rotavirus, it greatly reduces the severity of symptoms, ensuring that your child experiences only mild illness if they do contract the virus.

At Phoenix Medical Group, we offer the rotavirus vaccine as part of our comprehensive childhood immunisation services. Our healthcare professionals are here to guide parents through the vaccination process and ensure that your child receives the optimal protection against rotavirus in a safe and comfortable setting. 

How does a rotavirus vaccine work? 

The rotavirus vaccine is an oral, live-attenuated vaccine designed to train the immune system to recognise and fight off rotavirus infections. It contains a weakened form of the virus that does not cause illness but stimulates the body to build long-term immunity against future infections.

When a baby receives the rotavirus vaccine, the weakened virus in the vaccine replicates in the intestines, triggering an immune response. The body produces antibodies that specifically target rotavirus, which allows the immune system to quickly recognise and neutralise the virus if the child is exposed in the future. This process prevents severe infection and reduces symptoms, even if mild cases still occur.

There are two main rotavirus vaccines available in Singapore, both working on the same principle:

• Rotarix® (Two-Dose Vaccine) — contains a single strain of weakened human rotavirus. This helps infants develop immunity against the most common rotavirus types that cause severe disease.

• RotaTeq® (Three-Dose Vaccine) — contains five strains of weakened human-bovine (cow) reassortant rotavirus, providing broader protection against multiple strains of the virus.

Both vaccines mimic a natural infection, which allows the body to build strong, lasting immunity while avoiding the risks of severe illness caused by an actual rotavirus infection.

The vaccine provides strong immunity during early childhood, which is when children are most vulnerable to severe rotavirus infections. Natural exposure to the virus later in life continues to boost immunity, which is why severe rotavirus infections are rare in older children and adults.

What are the benefits of a rotavirus vaccine? 

Rotavirus vaccination is the most effective way to protect infants and young children from severe diarrhoea caused by rotavirus. It significantly reduces the risk of hospitalisation, complications, and the spread of infection within communities. Here are the key benefits of getting your child vaccinated:

• Prevents severe diarrhoea — reduces the risk of severe rotavirus-related diarrhoea, which can lead to dehydration and hospitalisation. 

• Reduces hospital admissions — countries with widespread rotavirus vaccination have seen a sharp decline in rotavirus-related hospitalisations. 

• Lowers the risk of dehydration — severe rotavirus infections can cause life-threatening dehydration, especially in infants, and vaccination helps prevent this. 

• Provides early protection — given in the first few months of life, the vaccine helps ensure immunity during the most vulnerable period. 

• Reduces the spread of infection — helps limit the circulation of rotavirus, which protects other children and vulnerable individuals. 

• Safe and well-tolerated — extensively tested and widely recommended by global and national health authorities. 

• No need for injections — given orally, which makes it painless and easy to administer. 

• Long-lasting immunity — protects throughout infancy and early childhood when the risk of severe rotavirus infection is highest. 

Who should get the rotavirus vaccine?

Vaccination provides strong protection during the most vulnerable early months of life. It is most recommended for:

• Babies attending daycare or having older siblings — higher exposure risk increases the likelihood of infection. 

• Infants born in families with frequent travel — higher chances of being exposed to different rotavirus strains.

• Children with mild or moderate gastrointestinal conditions — vaccination can prevent worsening dehydration from rotavirus infection. 

• Infants in multi-generational households — young children can unknowingly spread the virus to vulnerable family members. 

Who should not get the rotavirus vaccine?

While the rotavirus vaccine is safe and highly effective for most infants, there are certain situations where it may not be suitable. Parents should consult a doctor before proceeding with vaccination if their child has specific medical conditions or a history of severe allergic reactions.

Infants who should not receive the rotavirus vaccine: 

• Babies with a history of severe allergic reaction — infants who have had a life-threatening allergic reaction (anaphylaxis) to a previous dose of the rotavirus vaccine or any of its components should not receive further doses. 

• Infants with a history of intussusception — intussusception is a rare but serious bowel condition where one part of the intestine slides into another, causing a blockage. Babies who have previously had intussusception should not be vaccinated as the vaccine may slightly increase the risk. 

• Infants with severe combined immunodeficiency (SCID) — SCID is a rare genetic disorder where the immune system is extremely weak. Babies with this condition should not receive live vaccines, including the rotavirus vaccine. 

• Premature babies with ongoing medical complications — while most premature infants can safely receive the vaccine, those with unresolved health conditions should have their vaccination schedule assessed by a doctor. 

Infants who may need to delay vaccination

• Babies who are currently unwell with moderate or severe illness — if a baby has a high fever, severe diarrhoea, or vomiting at the time of vaccination, it is advisable to wait until they recover before receiving the vaccine. 

• Infants with a weakened immune system — babies undergoing treatment for certain medical conditions, such as cancer or organ transplantation, should have their immune status reviewed before vaccination. 

Rest assured, before any vaccination, our doctors assess each child’s medical history to determine whether the rotavirus vaccine is needed.

Are there any side effects of the rotavirus vaccine?

Like all vaccines, it can cause mild side effects in some babies, but serious reactions are extremely rare. 

Common side effects (mild and temporary)

These side effects usually resolve on their own within a few days:

• Mild diarrhoea or vomiting — some babies may have loose stools or mild vomiting after receiving the vaccine. 

• Irritability or fussiness — temporary discomfort or crankiness is common after vaccination. 

• Mild fever — a slight increase in body temperature may occur but typically settles within a day. 

Rare side effects

Although uncommon, some babies may experience the following:

• Severe allergic reaction (anaphylaxis) — this is extremely rare but can happen in infants who are allergic to a vaccine component. Symptoms include difficulty breathing, swelling of the face or lips, and hives. Immediate medical attention is required. 

• Intussusception — a very rare condition where part of the intestine folds into itself, causing a blockage. This occurs in approximately 1 to 2 cases per 100,000 vaccinated infants and usually happens within a week of the first or second dose. Parents should watch for signs such as severe stomach pain, inconsolable crying, vomiting, or bloody stools and seek urgent medical care if these symptoms occur. 

What to expect after my child receives the vaccine?

After your child receives the rotavirus vaccine, you can expect minimal discomfort, as the vaccine is administered orally rather than by injection. Most babies tolerate it well, and side effects, if any, are usually mild and short-lived.

Immediately after vaccination

• Your baby may swallow the oral vaccine easily, but some may spit out a small amount. If this happens, a repeat dose is not needed, as enough of the vaccine will still be absorbed. 

• There is no restriction on feeding, and you can breastfeed or bottle-feed as usual after vaccination. 

• Your baby can go home right away, but it’s advisable to stay at the clinic for 15–30 minutes in case of any immediate reaction (which is extremely rare). 

Possible reactions within the first few days

Most babies do not experience any side effects, but some may have:

• Mild diarrhoea or vomiting — usually resolves within a day or two.

• Increased fussiness or irritability — common with any vaccine, but should settle within 24 hours.

• Mild fever — can be managed with adequate hydration and light clothing.

Hygiene precautions after vaccination

Since the vaccine contains a weakened live virus, small amounts of the virus may be present in your baby’s stool for up to 10 days after vaccination. To reduce the risk of spreading the virus:

• Wash hands thoroughly after changing nappies. 

• Ensure proper hygiene when handling baby items like toys and feeding bottles. 

• Keep infants away from immunocompromised individuals, such as those undergoing chemotherapy or organ transplant recipients. 

Signs to watch for (seek medical attention if observed)

Although rare, contact a doctor immediately if your baby experiences:

• Persistent vomiting or severe diarrhoea leading to dehydration (fewer wet nappies, dry mouth, or lethargy). 

• High fever that does not subside. 

• Severe abdominal pain or inconsolable crying. 

• Blood in stools or symptoms of intussusception (sudden crying episodes, pulling legs towards the belly, vomiting). 

Summary

Rotavirus is a highly contagious virus that can cause severe diarrhoea, dehydration, and hospitalisation in infants and young children. Since there is no specific cure for rotavirus infection, vaccination is the most effective way to protect your child from its serious complications.

At Phoenix Medical, we provide comprehensive pre- and post-vaccination care and ensure that parents have all the information needed for a smooth experience. If you have any concerns after your child receives the rotavirus vaccine, book a consultation with us today. 

Frequently Asked Questions (FAQs)  

Can the rotavirus vaccine be given alongside other vaccines?

Yes, the rotavirus vaccine can be administered simultaneously with other routine childhood immunisations without affecting their effectiveness. ​

What should I do if my baby spits out the vaccine dose?

If an infant spits out or regurgitates the rotavirus vaccine, a replacement dose is not recommended. The infant should continue to receive any remaining doses in the recommended series. ​

Is the rotavirus vaccine effective in preventing severe disease?

Yes, the rotavirus vaccine is highly effective, with studies showing it prevents 85–98% of severe rotavirus infections, significantly reducing hospitalisations. ​

Can my child still get rotavirus after vaccination?

While the vaccine significantly reduces the risk of severe illness, it does not prevent all cases. Vaccinated children who do contract rotavirus typically experience milder symptoms. ​

Why was the first rotavirus vaccine withdrawn from the market?

The initial rotavirus vaccine, RotaShield, was withdrawn in 1999 due to an association with intussusception, a rare bowel obstruction. Current vaccines have undergone extensive testing and have a much lower risk. ​

How is the rotavirus vaccine administered?

The rotavirus vaccine is administered orally as a liquid, making it painless and easy for infants to receive. ​

What should I do if my child misses a scheduled rotavirus vaccination?

If your child misses a scheduled dose, consult your healthcare provider promptly. It’s important to complete the vaccination series before your child reaches 8 months of age.