Momtezuma Tuatara
09-02-09, 06:12 AM
http://www.medscape.com/viewarticle/587968?src=rss (http://www.medscape.com/viewarticle/587968?src=rss)
Specific changes to recommendations from 2006 ACIP statement are as follows:
Use of a second rotavirus vaccine, RV1, is acceptable. This is administered in a 2-dose series at ages 2 and 4 months.
The maximum age for dose 1 of rotavirus vaccine is now 14 weeks and 6 days, increased from the previous recommendation of 12 weeks.
The maximum age for the last dose of rotavirus vaccine is now to 8 months and 0 days, whereas the previous recommendation was 32 weeks.
Between doses of rotavirus vaccine, the minimum interval is now 4 weeks, and no maximum interval is set, whereas the previous recommendation was for a maximum interval of 410 weeks between doses.
The updated guidelines describe considerations that support rotavirus vaccination of HIV-exposed or HIV-infected infants.
Although the 2006 statement recommended deferring vaccination, if possible, for 42 days after receiving an antibody-containing product, the current statement allows for the administration of rotavirus vaccine at any time before, concurrent with, or after administration of any blood product, including antibody-containing products, following the routinely recommended schedule for rotavirus vaccine.
Specific recommendations for the routine use of rotavirus vaccine for US infants, and their accompanying level and strength-of-evidence rating, are as follows:
Routinely vaccinate with RV5 at ages 2, 4, and 6 months or with RV1 at ages 2 and 4 months (level of evidence, 1A).
Vaccine can be administered to breast-fed infants (level of evidence, 1A).
Vaccine can be coadministered with DTap, Hib vaccine, inactivated poliovirus vaccine, hepatitis B vaccine, and pneumococcal conjugate vaccine (level of evidence, 1A).
Vaccine can be administered to infants with mild gastroenteritis or other mild illness (level of evidence, 1B).
Either vaccine is contraindicated for infants who have had a severe allergic reaction to a vaccine component or previous vaccine dose (level of evidence, 3B).
Precautions for use of the vaccine include altered immunocompetence; moderate to severe illness, including gastroenteritis; chronic gastrointestinal disease; history of intussusceptions; and infants with spina bifida or bladder extrophy (all level of evidence, 3C).
Special situations discussed in the report include preterm infants (younger than 37 weeks; level of evidence, 1B), infants living in households with immunocompromised persons or with pregnant women, regurgitation of vaccine, infants hospitalized after vaccination, and infants who have received antibody-containing blood products (all level of evidence, 3C).
Specific changes to recommendations from 2006 ACIP statement are as follows:
Use of a second rotavirus vaccine, RV1, is acceptable. This is administered in a 2-dose series at ages 2 and 4 months.
The maximum age for dose 1 of rotavirus vaccine is now 14 weeks and 6 days, increased from the previous recommendation of 12 weeks.
The maximum age for the last dose of rotavirus vaccine is now to 8 months and 0 days, whereas the previous recommendation was 32 weeks.
Between doses of rotavirus vaccine, the minimum interval is now 4 weeks, and no maximum interval is set, whereas the previous recommendation was for a maximum interval of 410 weeks between doses.
The updated guidelines describe considerations that support rotavirus vaccination of HIV-exposed or HIV-infected infants.
Although the 2006 statement recommended deferring vaccination, if possible, for 42 days after receiving an antibody-containing product, the current statement allows for the administration of rotavirus vaccine at any time before, concurrent with, or after administration of any blood product, including antibody-containing products, following the routinely recommended schedule for rotavirus vaccine.
Specific recommendations for the routine use of rotavirus vaccine for US infants, and their accompanying level and strength-of-evidence rating, are as follows:
Routinely vaccinate with RV5 at ages 2, 4, and 6 months or with RV1 at ages 2 and 4 months (level of evidence, 1A).
Vaccine can be administered to breast-fed infants (level of evidence, 1A).
Vaccine can be coadministered with DTap, Hib vaccine, inactivated poliovirus vaccine, hepatitis B vaccine, and pneumococcal conjugate vaccine (level of evidence, 1A).
Vaccine can be administered to infants with mild gastroenteritis or other mild illness (level of evidence, 1B).
Either vaccine is contraindicated for infants who have had a severe allergic reaction to a vaccine component or previous vaccine dose (level of evidence, 3B).
Precautions for use of the vaccine include altered immunocompetence; moderate to severe illness, including gastroenteritis; chronic gastrointestinal disease; history of intussusceptions; and infants with spina bifida or bladder extrophy (all level of evidence, 3C).
Special situations discussed in the report include preterm infants (younger than 37 weeks; level of evidence, 1B), infants living in households with immunocompromised persons or with pregnant women, regurgitation of vaccine, infants hospitalized after vaccination, and infants who have received antibody-containing blood products (all level of evidence, 3C).