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This is VAERS ID 314408

Case Details

VAERS ID: 314408 (history)  
Form: Version 1.0  
Age: 5.0  
Gender: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:2008-05-01
Submitted: 2008-05-30
   Days after onset:29
Entered: 2008-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 2 MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, Intussusception
SMQs:, Gastrointestinal obstruction (narrow), Medication errors (narrow)

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: B0522166A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 5-year-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). On an unspecified date, the subject received 2nd dose of ROTARIX (oral), lot number not provided. In May 2008, at an unspecified time after vaccination with ROTARIX, the subject experienced intussusception. The subject was hospitalised. At the time of reporting the event was unresolved.


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