1. Age 6 weeks and 3 months: Vaccine against rotavirus
Rotavirus is the cause of approximately half of the cases of diarrhoea and vomiting among infants and toddlers. The virus spreads very easily.
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The usual route of infection is when a child puts their hand in their mouth after touching an object that is contaminated with rotavirus. Children excrete the virus in their stools before, during and after symptoms appear. Having a rotavirus infection only gives partial protection against re-infection, so most people will experience several episodes of rotavirus disease during childhood. Good hand hygiene reduces the spread of the virus but will not stop it completely.
Rotavirus disease often causes more severe symptoms than other gastrointestinal infections. Most children will recover without complications but some will need treatment for dehydration. If treatment begins too late, the disease can be fatal, although this happens rarely in Norway.
Before the introduction of the rotavirus vaccine in the Childhood Immunisation Programme, rotavirus disease was the cause of almost two-thirds of all admissions of young children to hospital with vomiting and diarrhoea. Every year, 700–1100 children with rotavirus disease were admitted to hospital for treatment and the majority were under 2-years-old.
The vaccine contains live, weakened rotavirus. The vaccine virus does not cause rotavirus disease among healthy children. The rotavirus vaccine is very effective and gives almost 100 % protection against severe rotavirus infection.
The rotavirus vaccine is given orally and has a sweet taste.
The vaccine used in the Childhood Immunisation Programme consists of 2 doses. The first dose is given at 6 weeks at the earliest, but no later than 12 weeks. The second dose is given when the child is 3 months of age, but no later than 16 weeks. Protection after vaccination lasts for 3–4 years. This is enough to protect the youngest and most vulnerable children.
Inform the public health clinic if the child has recently taken medicine, has an allergy or any other health problems. The nurse should also be informed if the mother has taken medicine that could affect the immune system during pregnancy or while breastfeeding because it may be necessary to delay vaccination with this vaccine.
Delay vaccination if the child has an acute infectious disease with fever over 38 ºC or an acute gastrointestinal infection with diarrhoea or vomiting.
Common side effects
The most common unwanted effects from the vaccine used in the Childhood Immunisation Programme are:
- Irritability and loose stools among 1 in 10 vaccinated children.
- Stomach pains, excess wind and skin reactions occur in up to 1 in 100 vaccinated children.
Intussusception is a rare condition among infants where a part of the intestine is pulled into itself. Every year in Norway, about 35–40 children under 1-year-old are admitted to hospital with intussusception. Studies have shown that this number may increase slightly after introducing the rotavirus vaccine (up to 1 extra case per 20,000 vaccinated), particularly when the vaccine is given after four months of age. Therefore the first dose should be given by the time the child is 12-weeks-old and the second dose when the child is 16-weeks-old. The first vaccine dose is given no later than 12 weeks and the second dose no later than 16 weeks.
The vaccine used is called Rotarix.