**Question:** Rotavirus vaccine - contraindication is -

A. Malignancy
B. Renal dysfunction
C. Inflammatory bowel disease
D. HIV infection

**Core Concept:** Contraindications to vaccination are medical conditions or circumstances that prevent a person from receiving a vaccine due to potential adverse reactions or compromised immune response.

**Why the Correct Answer is Right:** The rotavirus vaccine is contraindicated in individuals with HIV infection (D) because HIV profoundly suppresses the immune system, reducing the vaccine's effectiveness in preventing rotavirus gastroenteritis. Vaccine efficacy is compromised in patients with HIV, and they are at a higher risk of severe rotavirus infection.

**Why Each Wrong Option is Incorrect:**

A. Malignancy (Option A) is generally not a contraindication to vaccination unless the malignancy itself or its treatment is known to interfere with the immune system or pose a direct risk from the vaccine.

B. Renal dysfunction (Option B) is generally not a contraindication to vaccination unless severe impairment is present, leading to impaired immune response to vaccines. In milder cases, vaccination may still be safe and effective.

C. Inflammatory bowel disease (Option C) is generally not a contraindication to vaccination unless the disease is in an active phase or the patient is receiving immunosuppressive therapy, which could impair the immune response to vaccines.

**Clinical Pearl:** It is crucial to assess an individual's immune status and overall health prior to vaccinating, as some conditions or treatments may render vaccines less effective or potentially harmful. This ensures that vaccines are administered safely and optimally for the patient.

**Correct Answer:** D. HIV infection (Option D) is the correct answer because HIV infection compromises the immune system, leading to a decreased immune response to vaccines and increased risk of severe rotavirus infection.