Sibling transmission of vaccine-derived rotavirus (RotaTeq) associated with rotavirus gastroenteritis

Pediatrics. 2010 Feb;125(2):e438-41. doi: 10.1542/peds.2009-1901. Epub 2010 Jan 25.


Although rotavirus vaccines are known to be shed in stools, transmission of vaccine-derived virus to unvaccinated contacts resulting in symptomatic rotavirus gastroenteritis has not been reported to our knowledge. We document here the occurrence of vaccine-derived rotavirus (RotaTeq [Merck and Co, Whitehouse Station, NJ]) transmission from a vaccinated infant to an older, unvaccinated sibling, resulting in symptomatic rotavirus gastroenteritis that required emergency department care. Results of our investigation suggest that reassortment between vaccine component strains of genotypes P7[5]G1 and P1A[8]G6 occurred during replication either in the vaccinated infant or in the older sibling, raising the possibility that this reassortment may have increased the virulence of the vaccine-derived virus. Both children remain healthy 11 months after this event and are without underlying medical conditions.

Publication types

  • Case Reports

MeSH terms

  • Antigens, Viral / genetics
  • Capsid Proteins / genetics
  • Child, Preschool
  • Feces / virology
  • Gastroenteritis / genetics
  • Gastroenteritis / virology*
  • Humans
  • Infant
  • Male
  • Reassortant Viruses*
  • Rotavirus / pathogenicity
  • Rotavirus Infections / genetics
  • Rotavirus Infections / transmission*
  • Rotavirus Vaccines / adverse effects*
  • Rotavirus Vaccines / classification
  • Rotavirus Vaccines / genetics
  • Siblings
  • Vaccines, Attenuated / adverse effects
  • Vaccines, Attenuated / classification
  • Vaccines, Attenuated / genetics
  • Virulence
  • Virus Replication


  • Antigens, Viral
  • Capsid Proteins
  • RotaTeq
  • Rotavirus Vaccines
  • VP7 protein, Rotavirus
  • Vaccines, Attenuated