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This is VAERS ID 312637

(NOTE: This result is from the 5/13/2013 version of the VAERS database)

Case Details

VAERS ID: 312637 (history)  
Form: Version .0  
Age:   
Gender: Unknown  
Location: Foreign  
Vaccinated:0000-00-00
Onset:2008-05-01
Submitted: 2008-05-20
   Days after onset:19
Entered: 2008-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Intestinal resection, Intussusception
SMQs:, Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad)

Life Threatening? No
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: B0520205A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a child subject of unspecified gender who was vaccinated with ROTARIX (GlaxoSmithKline). This case has been reported to foreign regulatory authorities. The reporter stated that the child''s parent had a previous history of intussusception. On an unspecified date the subject received unspecified dose of ROTARIX (unknown). In May 2008, within 8 days of vaccination with ROTARIX, the subject experienced intussusception. The subject was hospitalised. The subject required bowel resection and remained in hospital. At the time of reporting the outcome of the event was unspecified. The reporter was not the treating physician and any attempts to request further information on this case would require consent from the patient.


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http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20130513&IDNUMBER=312637


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