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Prevention and Vaccines
As previously noted, hand washing with soap and water, diaper-changing hygiene, and water-purification systems are all necessary to deal with an established rotavirus outbreak. A proactive vaccination program of infants against rotavirus disease has been advocated by the CDC and the American Academy of Pediatrics for several years. Two oral vaccination products are currently licensed for use in the United States. RotaTeq was approved by the FDA in 2006. Three doses are required at 2, 4, and 6 months of age. More recently, Rotarix has been approved by the FDA. Two doses are required at 2 and 4 months of age. Both formulations show excellent effectiveness in preventing severe rotavirus disease (over 95%) and protection against severity of disease requiring hospitalization (85%). Side effects occur in only 1.3% of those receiving the vaccines (mild vomiting and diarrhea). It is recommended that whenever possible, patients should receive the same vaccine product throughout their immunization series.
A rotavirus vaccination product (RotaShield) was licensed for use in 1998 but was rapidly removed from use when postmarketing studies demonstrated an increase in the frequency of intussusception (a form of intestinal obstruction) in vaccine recipients. No such relationship (or any other form of intestinal obstruction) has been demonstrated with either RotaTeq or Rotarix.
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