A diagnostic quandary: Rotavirus vaccine associated diarrhea

The patient is an otherwise healthy two-month-old boy who received the recommended vaccinations for his age group, which included the rotavirus pentavalent vaccine (RV5; RotaTeq) at his two-month well child visit. Three days later, he developed prolonged non-bloody diarrhea and was found to have persis-tently positive rotavirus antigen in his stool. Subsequent workup revealed mild defects in his functional T-cell immunocompetence. Genetic testing was obtained through the Invitae panel and was negative for hereditary forms of primary immunodeficiencies. The rotavirus antigen was found to have cleared from his stool around four months after receiving the RV5. Unfortunately, the source of the rotavirus infection was unable to be determined. The caregivers had misconceptions about the vaccine and the child's immune system function which led to refusal of any further vaccinations. Healthcare providers should strive to develop honest and respectful relationships with parents to have thoughtful dialogues regarding vaccine safety and efficacy. & COPY; 2023 Elsevier Ltd. All rights reserved.

Automated summary

A healthy two-month-old boy developed prolonged non-bloody diarrhea after receiving the rotavirus pentavalent vaccine. Further investigation revealed mild defects in his T-cell immunocompetence and ruled out hereditary forms of primary immunodeficiencies. The source of the rotavirus infection could not be determined, and the caregivers refused further vaccinations due to misconceptions.