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This is VAERS ID 274556

Case Details

VAERS ID: 274556 (history)  
Form: Version 1.0  
Age: 0.35  
Gender: Male  
Location: Missouri  
Vaccinated:2006-11-06
Onset:2006-12-09
   Days after vaccination:33
Submitted: 2007-03-22
   Days after onset:102
Entered: 2007-03-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS ? / 2 UN / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / -
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / 2 UN / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. ? / 2 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Barium double contrast, Bowel movement irregularity, Cold sweat, Crying, Decreased appetite, Foaming at mouth, Haematochezia, Hypotonia, Insomnia, Intussusception, Irritability, Pain, Screaming, Shock, Stomach discomfort, Thrombosis, Ultrasound abdomen, Vomiting, Wheezing, X-ray
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Convulsions (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Ischaemic colitis (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zantac
Current Illness:
Preexisting Conditions: Reflux PMH: GERD, bilat ing hernia repair, chickenpox, Birth HX: full term, unremarkable
Allergies:
Diagnostic Lab Data: LABS: air contrast enema revealed & successfully treated IS. No x-ray reports included w/records.
CDC Split Type:

Write-up: Our son has been having severe bowel cramping ever since the first dose of the rotavirus vaccine RotaTeq. He has suffered from abdominal cramping, severe crying spells, problems passing bowel movements, decreased appetite, fussiness, and loss of sleep. After having the second dose of the vaccine, his symptoms worsened until he finally developed intussuception. The day he developed this adverse reaction he began the morning with his usual fussiness. He hadn''t slept well the night before and was having trouble being held and bending in the middle. As I tried to give him his morning feeding, he persistantly refused to nurse and became more and more fussy. He arched his back and his stomach became hard. He began screaming out in pain and essentially foaming at the mouth. Following a severe screaming and crying spell, he went into shock. His skin became cool and clammy and he went limp in my arms. We called the pediatrician and they told us to take a rectal temperature. While taking a rectal tempature he passed a large bowel movement containing jelly-like blood clots. We rushed him to the emeregency room where he began to wheeze and vomit up bile. They took an X-ray of his abdomin, and followed up the X-ray with an ultrasound. The ultrasound confirmed the bowel telescoping. They did an air contrast enema to reduce the obstruction and then kept him in the hospital for the next two days for monitoring. When we met with our pediatrician following the intussuception, he didn''t mention that it could be related to the rotavirus vaccine. He went ahead and administered the third dose of the vaccine about a month after our son''s hospitalization. Since the third dose of the vaccine, we have been back to the emergency room with the same symptoms, but the bowel twisting has resolved itself without further medical enemas. 3/23/07 Received ER medical records which reveal patient experienced nasal congestion, pulling at left ear & irritability for approx 3 days prior to being seen in ER on 3/18/07. Exam revealed reddened left TM. PMH: s/p IS 3 wks ago. FINAL DX: left otitis media. 4/13/07 Received medical records from treating hospital which reveals patient experienced jaw clenching, diaphoresis, screaming, pallor, gen fussiness & bloody stools. In ER had bilious vomiting. Held overnight s/p IS reduction by enema. Progressed well & d/c to home. FINAL DX: Intussusception, reduced by air contrast enema.


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