Rotarix® and RotaTeq® administration to preterm infants in the neonatal intensive care unit: Review of available evidence

Abstract

Rotavirus (RV) is the leading cause of severe acute gastroenteritis (GE) in infants worldwide. Several vaccines against RV were developed to reduce disease burden, hospitalization rates and health utilization costs. RV GE is a serious disease in preterm (PT) infants, and the administration of RV vaccine to these at-risk subjects at the proper time could have great clinical relevance. However, most data on the efficacy and safety of RV vaccinations were collected in healthy full-term infants, and few studies investigated PT infants. The lack of studies in PT infants may explain why neonatologists in several neonatal intensive care units (NICUs) do not follow the official recommendations, which indicate that RV vaccine may be administered in hospitals. Increasing neonatologists' knowledge on the efficacy and safety of RV vaccines and defining PT candidates for vaccination and the necessary precautions are extremely important to avoid potential vaccine virus transmission and improve RV vaccination coverage in PT infants. Further studies should analyse the impact of vaccination of PT infants of different gestational ages and various clinical histories in stable conditions in the NICU with a careful monitoring of adverse events to the vaccine and RV GE occurrence. Only data that confirm the efficacy and safety of RV vaccines in large numbers of PT infants with different characteristics will convince neonatologists to use RV vaccines in PT infants hospitalized in NICUs.

Keywords: Acute gastroenteritis; Preterm infants; Rotarix; Rotateq; Rotavirus; Rotavirus vaccine.