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This is VAERS ID 311333

(NOTE: This result is from the 12/8/2009 version of the VAERS database)

Case Details

VAERS ID: 311333 (history)  
Form: Version .0  
Age: 0.4  
Gender: Female  
Location: Foreign  
Vaccinated:2008-04-10
Onset:2008-04-16
   Days after vaccination:6
Submitted: 2008-04-30
   Days after onset:14
Entered: 2008-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - - / PO

Administered by: Other       Purchased by: Other
Symptoms: Abdominal distension, Intestinal obstruction, Intussusception, Surgery, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal obstruction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 0 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: B0517644A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 5-month-old female subject who was vaccinated with Rotarix (GlaxoSmithKline). No concomitant medication was given to the subject. On 10 April 2008, the subject received unspecified dose of Rotarix (oral), lot number not provided. On 16 April 2008, 6 days after vaccination with Rotarix, the subject experienced abdominal distension and vomiting. On 18 April 2008, the subject was hospitalised. The exam performed showed intestinal obstruction. A surgery was performed and intussusception was found. The physician considered the events were life threatening and clinically significant (or requiring intervention). At the time of reporting the events were improved.


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http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20091208&IDNUMBER=311333


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