Rotavirus the vaccine is Rotarix. The strain in

Rotavirus Vaccine

Summary Product
characteristics

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Rotavirus vaccine was first
introduced in the UK in July 2013. The vaccine is given to the children for the
protection against rotavirus infection which results in vomiting and diarrhoea
therefore causing dehydration in infants and children.  (Vaccine Knowledge project, 2018)

 Vaccine name/trade name (UK)

In the UK the brand name of
the vaccine is Rotarix. The strain in this vaccine is Human rotavirus RIX4414, grown in Laboratory
using animal cell-lines. (emc,2017)

There are five live stains in
the vaccine; G1, G2, G3, G4, and P1.

Routes
of administration

Rotavirus vaccine is administrated
orally. It is only available as an oral suspension. The vaccine should be
administered using an oral applicator gently into the inner cheek as shown in
figure 1. It shouldn’t be given as an injection under any circumstances.

Figure 1. instructions on
administration of the vaccine. (emc, 2017)

 

Pharmaceutical
form

The vaccine has an appearance
of clear liquid as shown below in figure 2. (World Health Organisation, 2013)

List of excipients include
Sucrose, Di-sodium Adipate, Dulbecco’s Modified Eagle Medium (DMEM) and Sterile
water.  (emc, 2017)

(mims.co.uk, 2013)

Figure 2 shows the packaging
of Rotavirus Vaccine

Dosage
forms

The vaccine should be first
administered at the beginning of 6 weeks and the course should be completed by
24 weeks of age. 2 doses of 1.5 mL Rotarix administered at least 4 weeks apart.
(Joint Formulary Committee, 2017-2018)

Storage

Should be stored
refrigerated under 2- 8 degreesThe vaccine should
be administered within 24 hours of reconstitution.Do not freeze.Keep away from
light

(Joint
Formulary committee 2017-2018)

 

Therapeutic
Indication

Rotavirus vaccines are aimed
for children aged 6-24 weeks to avoid gastro- enteritis. (emc, 2017)

What is
gastro-enteritis?

Gastro- enteritis is the
inflammation of the stomach and small intestines which results in vomiting and
severe diarrhoea. (Nhs.uk, 2017)

Contraindications

Rotavirus vaccine is
contradicted for:

Infants who had allergic reaction from the first
dose of Rotarix.Infants who have severe combined immunodeficiency
(SCID).Infants who previously had intussusception.

(CDC.gov, 2011)

What is
intussusception?

Intussusception is the
telescoping of one part of the intestine into the other which also involves any
veins and nerves therefore resulting in compression of the veins. This is
common amongst infants aged three months to five-year olds. (Nhs.uk, 2016)

The
Immune System

The main organs of the immune
system are:

Bone marrow: B cells are
produced and matured.

Thymus: T cells are matured.

Lymph nodes/Spleen: T and B
cells get activated when the antigens are presented.

Vaccination is a way of
stimulating the immune system to provide protection from disease caused by a
pathogen without subjecting the host to disease. When the phagocytes detect a
foreign antigen, they engulf them in the phagocytotic vacuole by phagocytosis.
In the vacuole, there are lysozymes that hydrolysis the antigen. The antigen is
then presented on the macrophages which is called antigen presentation. Another
important process before phagocytosis is opsonisation which is a mean of
identifying the invading particle to the phagocyte. This is innate immunity, it
is non-specific and not adaptable.

(generativemedicine.org,2006)

The two main types of
lymphocytes are B cells and T cells which are part of adaptive immunity also
known as acquired or cell mediated immunity.

B cells contribute towards
humoral component of adaptive immune system. The main function of the B cells
is to produce memory B cells, antibodies, antigen presentation and cytokine
secretion. B cells produce five types of antibodies that bind to antigens and
form antibody-antigen complex, which are then cleared by liver or spleen.

T cell lymphocytes main
function is specificity and memory. It directly destroys the infected cells and
remembers the antigens presented before. Clonal selection takes place where the
T cells are differentiated into helper T cells, killer T cells and memory T
cells.

(Pearson education, 2011)

Once the vaccine has produced
memory B cells and T cells. The second time a person gets infected with
rotavirus, it is detected by memory T cell and memory B cell which produce
antibodies complimentary to the antigen. The removal of the virus is quicker
because of the memory cells and immune homeostasis is restored.

Benefits
of vaccination

One of the most important
benefits of vaccination is herd immunity. Herd immunity is when most of the
population is vaccinated against a virus, it is less likely for an infection to
pass on. This is beneficial for the people who are not vaccinated for the
infection.

Other benefits include:

Elimination of the diseaseExtending life expectancyHealth care and other savings for society

(World Health Organisation,
2008)

Current
use and effectiveness of Rotavirus Vaccine in the UK

A report was carried out from
February 2014 to March 2015 which looked at the percentage of children who took
rotavirus vaccine since the year the vaccine was introduced (July 2013).

The results were collected by
looking at the numbers of infants registered with the GP and reached the age of
25 weeks and number of infants administered with first and second dose of
rotavirus vaccine. The following results were found:

Rotavirus vaccine coverage for the first dose
averaged 99.3%Rotavirus vaccine coverage for two doses averaged
88.3%

This suggests that the current
use of the vaccine is quite high so therefore more beneficial for the
population. (gov.uk, 2015)

Effectiveness of
the vaccine

Following the introduction of
the rotavirus vaccine, the experts made a prediction that the number of
rotavirus cases presented to the GP will decrease by half after 1 year. They
also made a prediction that the hospital cases will drop to two thirds. The
results of the research are illustrated below in the bar chart.

(Vaccine Knowledge Project,
2018)

The bar chart shows the cases
for rotavirus presented to the GP decreased to 70% in 2014 and 2015.

Current
use in children/ adults/ elderly/ pregnancy

Children

Rotavirus vaccine is
recommended for children at the age of 6 weeks and the course of two doses
should be finished by the age of 25 weeks.

Adults

Not recommended for adults.

Pregnancy

There is no data on the use of
rotarix during pregnancy.

Breast feeding

There is no evidence to show
the decreased protection of the vaccine is due to breastfeeding. So, it is
appropriate to breast feed during vaccinations. (emc, 2017)

FAQs

How do you get rotavirus?

Rotavirus is very contagious, it can be spread by
touching an infected person’s stool and not washing hands afterwards. 

 

My child is vaccinated against rotavirus so does
that mean he won’t get the virus in the future?

What happens if the baby spits out the vaccine?

In
that case, another dose can be provided on the same visit.

risks of vaccination

risks of not vaccinating

side effects of the vaccination

Myths about vaccinations

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