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Safety of Rotavirus Vaccination in a Growing Care Unit (Intermediate-care Neonatal Unit) in Japan

Hiroki Miura1, Masahiko Manabe1, Masaru Ihira2

  • 1From the Department of Pediatrics, Fujita Health University School of Medicine.

The Pediatric Infectious Disease Journal
|April 22, 2026
PubMed

Insights

In-hospital rotavirus vaccination (RV1) in neonatal step-down units is safe, with no serious adverse events or detectable transmission. This approach ensures high-risk infants receive crucial immunization, preventing missed vaccination opportunities.

Area of Science:

  • Neonatal care
  • Vaccinology
  • Infectious disease prevention

Background:

  • Rotavirus vaccination prevents severe gastroenteritis but is often withheld during neonatal hospitalization due to transmission concerns.
  • Limited data exists on the safety of in-hospital rotavirus vaccination in neonatal step-down units.

Purpose of the Study:

  • To evaluate the safety and potential transmission of monovalent rotavirus vaccine (RV1) administered during hospitalization in a neonatal step-down care setting.
  • To assess the feasibility of in-hospital vaccination to prevent missed immunization opportunities in high-risk infants.

Main Methods:

  • A prospective cohort study was conducted in a Japanese growing care unit (neonatal step-down unit).
  • Infants received monovalent rotavirus vaccine (RV1); stool samples were analyzed for vaccine-strain RNA using real-time quantitative RT-PCR.
  • Adverse events and vaccine-strain shedding were monitored under routine contact precautions.

Main Results:

  • RV1 vaccine-strain RNA was detected in 68.4% of postvaccination stool samples from vaccinated infants.
  • No serious adverse events were observed, and no evidence of horizontal transmission was found.
  • In-hospital vaccination allowed six infants who exceeded the age limit at discharge to receive vaccination.

Conclusions:

  • Monovalent rotavirus vaccine (RV1) administration in neonatal step-down units is safe, with no detectable transmission or serious adverse events.
  • In-hospital vaccination is a viable strategy to ensure high-risk infants receive timely rotavirus immunization.
  • This approach addresses missed vaccination opportunities among vulnerable hospitalized neonates.
Abstract

Keywords:
growing care unitrotavirusrotavirus1safety of rotavirus vaccinationvaccine

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