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This is VAERS ID 316757

Case Details

VAERS ID: 316757 (history)  
Form: Version 1.0  
Age: 0.2  
Gender: Male  
Location: Foreign  
Vaccinated:2007-05-22
Onset:2007-06-01
   Days after vaccination:10
Submitted: 2008-06-20
   Days after onset:385
Entered: 2008-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Enema administration, Haematochezia, Intussusception, Megacolon, Pain, Ultrasound abdomen abnormal, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (narrow), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (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: Ultrasound abdomen, 09Jun2007, Abnormal
CDC Split Type: B0477134A

Write-up: This case was reported by a physician and described the occurrence of intussusception of intestine in a 2-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). On 22 May 2007, the subject received a dose of ROTARIX (batch number not available, oral). At an unspecified date later, he presented with serious bloody stools, vomiting and pain. The subject was hospitalised. On 09 June 2007, an abdomen ultrasound was performed. Diagnosis of intussusception of intestine was made. Under enema with hydrosolubles, a colo-colic desinvagination was performed with mild difficulties. According to the radiologist, the subject had a megacolon. Within an unspecified delay, the events resolved. The reporter''s causality assessment was unknown. Follow up on 11 June 2008: This case has been closed. No more information will be available.


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