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This is VAERS ID 314409

Case Details

VAERS ID: 314409 (history)  
Form: Version 1.0  
Age: 0.3  
Gender: Female  
Location: Foreign  
Vaccinated:2008-04-30
Onset:2008-05-05
   Days after vaccination:5
Submitted: 2008-05-30
   Days after onset:25
Entered: 2008-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Enema administration, Intussusception, Malaise, Ultrasound abdomen abnormal
SMQs:, Retroperitoneal fibrosis (broad), Gastrointestinal obstruction (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ultrasound abdomen, 06May2008, ISunit
CDC Split Type: B0522202A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 3-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject was in her weight and size according to her age and in good health. The subject''s did not have any medical history of intussusception. She had a twin sister who received ROTARIX the same day without developing any adverse event. On 30 April 2008 the subject received 1st dose of ROTARIX (oral) lot number not provided. On 5 May 2008, 5 days after vaccination with ROTARIX, the subject started to feeling unwell. On 06 May 2008 the subject was brought to hospital and intussusception was diagnosed after abdominal ultrasound. The subject did not have fever or diarrhea or bloody stools. The subject was hospitalised for 5 days and discharged completely recovered. The subject was treated with enema. The physician considered the events were almost certainly related to vaccination with ROTARIX. Further information was not expected and therefore this case has been closed.


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