Vaccine-acquired rotavirus in infants with severe combined immunodeficiency

N Engl J Med. 2010 Jan 28;362(4):314-9. doi: 10.1056/NEJMoa0904485.


Live pentavalent human-bovine reassortant rotavirus vaccine is recommended in the United States for routine immunization of infants. We describe three infants, two with failure to thrive, who had dehydration and diarrhea within 1 month after their first or second rotavirus immunization and subsequently received a diagnosis of severe combined immunodeficiency. Rotavirus was detected, by means of reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay, in stool specimens obtained from all three infants, and gene-sequence analysis revealed the presence of vaccine rotavirus. These infections raise concerns regarding the safety of rotavirus vaccine in severely immunocompromised patients.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • DNA, Viral / analysis
  • Dehydration / etiology
  • Diarrhea, Infantile / etiology
  • Failure to Thrive / etiology
  • Feces / virology
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • RNA, Viral / analysis
  • Reverse Transcriptase Polymerase Chain Reaction
  • Rotavirus / genetics
  • Rotavirus / isolation & purification*
  • Rotavirus Infections / etiology*
  • Rotavirus Infections / virology
  • Rotavirus Vaccines / adverse effects*
  • Sequence Alignment
  • Sequence Analysis, DNA
  • Severe Combined Immunodeficiency / complications*
  • Severe Combined Immunodeficiency / therapy
  • Stem Cell Transplantation
  • Virus Shedding


  • DNA, Viral
  • RNA, Viral
  • Rotavirus Vaccines