With there being so much debate and discussion regarding vaccinations these days, I thought I'd take this opportunity to briefly acknowledge a "new" vaccine and the impact it is already having on a virus that can be quite cruel to children here in the United States and worldwide. Rotavirus is the most common cause of gastroenteritis in young children (less than 5 years of age) during the winter (and often into the spring) here in the United States. 

The symptoms of vomiting and profuse, watery diarrhea typically last for 3-8 days, often accompanied by fever and abdominal pain. In the United States, 55,000 children each year are hospitalized secondary to the dehydration that follows, and worldwide, over 600,000 children die annually. It has a short incubation, about 2-4 days (exposed on Friday, symptoms by Monday) and because no specific antiviral medications exist, treatment is primarily supportive: intravenous (IV) or oral fluids. So in light of the path of destruction it creates and without a specific treatment measure, the importance of having a safe and effective vaccine appears quite obvious to me.

It appears we now have one (and possibly another soon to follow) that is indeed both safe and effective. In early 2006, the Food and Drug Administration (FDA) approved Rotateq, a live oral (by mouth) vaccine and according to the Centers for Disease Control and Prevention (CDC), this past winter season showed significantly decreased numbers of rotavirus cases when compared to the previous two years. In fact, in my office alone, I clearly noted a significant decrease in cases from just the year before and, in fact, no hospitalizations (something that pleasantly surprised me and my colleagues). Now some of you may recall there being another rotavirus vaccine that was withdrawn from the market in 1999 following an increased association with intussusception (an intestinal blockage emergency) but large population based studies to date have not shown this same occurrence with Rotateq.

For more specifics regarding the administration schedule and potential adverse effects I've attached a link to the Merck & Co. website:

http://www.merck.com/product/usa/pi_circulars/r/rotateq/rotateq_ppi.pdf. 

But for those with newborns, I want to remind you all of the dosing schedule as the first of the three doses must be given between 6-12 weeks of age with the second 4-10 weeks later and the third 4-10 weeks after the 2^nd dose.  Also, the 3^rd dose must be given by 32 weeks of age (around 8 months of age).  So please discuss with your child's physician if it isn't discussed with you.

Dr. Jeremy

(And please note I have no financial relationship with Merck & Co.)