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April 13, 2026Journal of Medical Virology0 citationsOpen Access

Rotavirus Vaccine Breakthrough With Vaccine‐Modified Disease in a Sibling Cluster of Equine‐Like G3P8 Infection

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ATAhmad Syatir TaharEOEng Joe OngDMDewi Mamora

Key Points

  • This research aims to understand the impact of the RotaTeq vaccine on disease severity in rotavirus infections among siblings.
  • Case report of a sibling cluster with rotavirus infections
  • Assessment of disease severity using the modified Vesikari score
  • Rapid antigen testing and molecular analysis for rotavirus identification
  • Epitope analysis of the VP7 protein for genetic differences
  • Unvaccinated siblings experienced severe gastroenteritis and prolonged hospitalization
  • Vaccinated sibling had milder symptoms and shorter hospitalization
  • Disease severity scores indicated severe disease in unvaccinated siblings and moderate disease in the vaccinated child
  • Genetic analysis revealed four nonsynonymous substitutions in the VP7 protein compared to the vaccine strain

Abstract

ABSTRACT Rotavirus remains one of the major causes of childhood gastroenteritis despite the widespread introduction of rotavirus vaccines. Here, we report a sibling cluster of three children hospitalized with fever, vomiting, and diarrhea. Two unvaccinated siblings (11 years 9 months and 10 years 1 month) developed severe gastroenteritis with profuse watery diarrhea and prolonged hospitalization, while the youngest sibling (3 years 4 months), fully vaccinated with the RotaTeq vaccine, developed milder symptoms and had a shorter duration of hospitalization. Disease severity assessed using the modified Vesikari score indicated severe disease in the unvaccinated siblings (scores 16 and 11) and moderate disease in the vaccinated child (score 10). Rapid antigen testing followed by molecular analysis confirmed equine‐like G3P8 rotavirus infections in all three patients. Epitope analysis of the VP7 protein identified four nonsynonymous substitutions (T87S, N213T, K238D, and D242A) within antigenic regions compared with the RotaTeq G3 vaccine strain. The reduced disease severity in the vaccinated sibling suggests partial protection conferred by the RotaTeq vaccine despite breakthrough infection and highlights the importance of continued molecular surveillance of circulating rotavirus strains.

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Cite This Study

Tahar et al. (2026) studied this question.

synapsesocial.com/papers/69dc88303afacbeac03ea1c6https://doi.org/10.1002/jmv.70910
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