{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T20:13:34Z","timestamp":1791922414856,"version":"4.3.4"},"reference-count":56,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To review current evidence regarding the occurrence, clinical presentation, and management of gastrointestinal adverse events following administration of RV1 and RV5 rotavirus vaccines in the paediatric population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic literature search was performed between April and August 2025. The review included randomised controlled trials, meta\u2010analyses, and relevant case reports published from 2007 onwards. Primary outcomes focused on gastrointestinal manifestations: Prolongeddiarrhoea, intussusception, and immune\u2010mediated diseases. Secondary outcomes included clinical management of GI post\u2010vaccination events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Out of 197 identified studies, 86 met the inclusion criteria. Mild gastrointestinal symptoms, such as transient diarrhoea and vomiting, were common but typically self\u2010limited. No increased risk of prolonged diarrhoea was identified in healthy infants, although rare cases were reported in children with severe immunodeficiencies. Data showed no increased risk of intussusception or immune\u2010mediated conditions like celiac disease or inflammatory bowel disease. Specific high\u2010risk groups, including infants with a history of intussusception, severe combined immunodeficiency, or metabolic disorders, were associated with a higher incidence of adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>RV1 and RV5 vaccines maintain an excellent safety profile. In high\u2010income settings, prolonged post\u2010vaccination diarrhoea should be considered a clinical marker for underlying immunodeficiency rather than a risk factor for future immune\u2010mediated intestinal disorders.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apa.70709","type":"journal-article","created":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T11:20:55Z","timestamp":1785583255000},"page":"2389-2397","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Gastrointestinal Adverse Events Following Rotavirus Vaccination in Children: A Systematic Review"],"prefix":"10.1111","volume":"115","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4965-2689","authenticated-orcid":false,"given":"Francesca","family":"Musto","sequence":"first","affiliation":[{"name":"Pediatric Gastroenterology, Hepatology and Cystic Fibrosis Unit Fondazione IRCCS C\u00e0 Granda, Ospedale Maggiore Policlinico Di Milano  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4578-0066","authenticated-orcid":false,"given":"Antonio","family":"Corsello","sequence":"additional","affiliation":[{"name":"Department of Clinical\u2010Surgical, Diagnostic and Pediatric Sciences University of Pavia  Pavia Italy"},{"name":"Pediatric Gastroenterology Unit Children's Hospital \u201cG. Di Cristina\u201d, ARNAS Civico\u2010Di Cristina\u2010Benfratelli  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7226-6994","authenticated-orcid":false,"given":"Sara","family":"Curto","sequence":"additional","affiliation":[{"name":"Pediatrics and Pediatric Emergency Unit Children's Hospital, \u201cU. Bosio\u201d Center for Digestive Diseases, AOU \u201cSS. Antonio e Biagio e Cesare Arrigo\u201d  Alessandria Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Logrieco","sequence":"additional","affiliation":[{"name":"Department of Biomedicine and Prevention PhD in Immunology, Molecular, Medicine and Applied Biotechnology, University of Rome Tor Vergata  Rome Italy"},{"name":"Gastroenterology and Nutrition Unit Bambino Ges\u00f9 Children Hospital IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Mellos","sequence":"additional","affiliation":[{"name":"Pediatrics Unit San Giuseppe Hospital  Empoli Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Guercio Nuzio","sequence":"additional","affiliation":[{"name":"Pediatric Unit, Department of Women's and Children's Health S. Maria Della Speranza Hospital of Battipaglia  Salerno Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Claudia","family":"Romeo","sequence":"additional","affiliation":[{"name":"Department of Paediatrics UniCamillus \u2010 Saint Camillus International University of Health and Medical Sciences  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2179-5992","authenticated-orcid":false,"given":"Giuseppe","family":"Stella","sequence":"additional","affiliation":[{"name":"UOSD Spina Bifida and Other Specialist Branches, Department of Woman and Child Health and Public Health Fondazione Policlinico Gemelli IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5249-8248","authenticated-orcid":false,"given":"Matteo","family":"Bramuzzo","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health \u2010 IRCCS \u201cBurlo Garofolo\u201d  Trieste Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,1]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD008521.pub6"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2021.0347"},{"issue":"4","key":"e_1_2_12_4_1","first-page":"81","article-title":"Centers for Disease Control and Prevention (CDC). Notes From the Field: Rotavirus Vaccine Administration Errors \u2013 United States, 2006\u20132013","volume":"63","author":"Hibbs B. F.","year":"2014","journal-title":"MMWR. Morbidity and Mortality Weekly Report"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.97"},{"issue":"15","key":"e_1_2_12_6_1","first-page":"398","article-title":"Rotavirus Vaccination Coverage and Adherence to the Advisory Committee on Immunization Practices (ACIP)\u2010Recommended Vaccination Schedule \u2013 United States, February 2006\u2013May 2007","volume":"57","author":"Centers for Disease Control and Prevention (CDC); Advisory Committee on Immunization Practices (ACIP)","year":"2008","journal-title":"MMWR. Morbidity and Mortality Weekly Report"},{"key":"e_1_2_12_7_1","unstructured":"ROTARIX \u201cFDA Drug Label. Food and Drug Administration (DailyMed) \u201dhttp:\/\/www.fda.gov\/vaccines\u2010blood\u2010biologics\/vaccines\/rotarix."},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1586\/erv.09.136"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1586\/14760584.6.1.11"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1517\/14712590903103787"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1586\/14760584.2014.942223"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40264\u2010021\u201001141\u20104"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2025.2465161"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39489.470347.AD"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12026\u2010013\u20108420\u20100"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2020.11.026"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.4161\/hv.26319"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.inf.0000164763.55558.71"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2021.03.079"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2022.02.003"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2022.951127"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010022\u201017187\u2010y"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu15245100"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268823000936"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2021.05.032"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.15830"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ram.2020.10.002"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2010.07.039"},{"key":"e_1_2_12_29_1","volume-title":"Fields Virology","author":"Estes M. K.","year":"2007"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1177\/1740774508090507"},{"issue":"5","key":"e_1_2_12_31_1","first-page":"49","article-title":"Rotavirus Vaccines: WHO Position Paper \u2013 January 2013","volume":"88","author":"World Health Organization","year":"2013","journal-title":"Weekly Epidemiological Record"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2009.07.005"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jped.2022.12.001"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1086\/431512"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1303164"},{"issue":"95","key":"e_1_2_12_36_1","first-page":"25","article-title":"4\u20135 December 2019","volume":"4","author":"Global Advisory Committee on Vaccine Safety","year":"2020","journal-title":"Weekly Epidemiological Record"},{"issue":"28","key":"e_1_2_12_37_1","first-page":"301","article-title":"Rotavirus Vaccines: WHO Position Paper \u2013 July 2021","volume":"96","author":"World Health Organization","year":"2021","journal-title":"Weekly Epidemiological Record"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1356932"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiac038"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473\u20103099(22)00368\u20101"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2019.09.088"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001330"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2011.07.117"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000000361"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440\u20101754.2011.02227.x"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2021\u2010051901"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpids\/pit060"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.aah5298"},{"key":"e_1_2_12_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2020.04.041"},{"key":"e_1_2_12_50_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0030358"},{"key":"e_1_2_12_51_1","doi-asserted-by":"publisher","DOI":"10.1111\/cei.12855"},{"key":"e_1_2_12_52_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000002281"},{"issue":"1","key":"e_1_2_12_53_1","first-page":"151","article-title":"Paediatric Rotavirus Vaccination, Coeliac Disease and Type 1 Diabetes in Children: A Population\u2010Based Cohort Study","volume":"19","author":"Pasvol T. J.","year":"2021","journal-title":"BMC Medicine"},{"key":"e_1_2_12_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2016.10.033"},{"key":"e_1_2_12_55_1","doi-asserted-by":"publisher","DOI":"10.3920\/BM2022.0024"},{"key":"e_1_2_12_56_1","doi-asserted-by":"publisher","DOI":"10.4161\/hv.29280"},{"key":"e_1_2_12_57_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005176\u2010199705000\u201000024"}],"container-title":["Acta Paediatrica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apa.70709","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/apa.70709","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apa.70709","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T08:16:32Z","timestamp":1791879392000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apa.70709"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,1]]},"references-count":56,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1111\/apa.70709"],"URL":"https:\/\/doi.org\/10.1111\/apa.70709","archive":["Portico"],"relation":{},"ISSN":["0803-5253","1651-2227"],"issn-type":[{"value":"0803-5253","type":"print"},{"value":"1651-2227","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,1]]},"assertion":[{"value":"2026-05-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}