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This is VAERS ID 314412

Case Details

VAERS ID: 314412 (history)  
Form: Version 1.0  
Age: 0.3  
Gender: Female  
Location: Foreign  
Vaccinated:2008-02-08
Onset:2008-02-13
   Days after vaccination:5
Submitted: 2008-05-30
   Days after onset:106
Entered: 2008-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Intussusception
SMQs:, 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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: D0057465A

Write-up: This three-month-old female subject was enrolled in a epidemiological study to gather epidemiological back-ground data on the incidence of intussusception. The subject received oral ROTARIX on 08 February 2008. On 13 February 2008, five days after vaccination with ROTARIX, this three-month-old subject developed intussusception. The subject was hospitalised for 2 days. The disease took an uncomplicated course. The event resolved on 14 February 2008 and the subject was discharged after successful reposition. Investigator causality was unknown at the time of reporting. Follow-up information has been requested.


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