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This is VAERS ID 320341

Case Details

VAERS ID: 320341 (history)  
Form: Version 1.0  
Age: 0.6  
Gender: Male  
Location: Unknown  
Vaccinated:2008-07-10
Onset:2008-07-15
   Days after vaccination:5
Submitted: 2008-07-23
   Days after onset:8
Entered: 2008-07-24
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS ACZ21B142 / 3 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C68310 / 3 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 02151X / 3 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown 8/4/08-records received- Ultrasound suggested intussusception. Barium enema confirmed but unsuccessful reduction. Surgical reduction of ileocecal intussusception with necrotic ileoileal part resected. Stool positive for rotovirus. Labs WNL.
CDC Split Type: WAES0807USA03381

Write-up: Information has been received from a consumer concerning her son, a 6 month old male who on 10-JUL-2008 was vaccinated with his third dose of ROTATEQ (Lot # not reported). The consumer reported that her son had received his third dose of ROTATEQ on 10-JUL-2008. Approximately 24 hours after receiving dose, the patient experienced intussusception. The patient was rushed to the emergency room and needed surgery. He was hospitalized from 11-JUL-2008 to 16-JUL-2008. ROTATEQ was not reintroduced. The patient was considered to be not recovered. The reported considered intussusception as an other important medical event. There was no product quality complaint. Additional information has been requested.8/4/08-records received for DOS 7/16-7/22/08-DC DX: Intussusception. Laparotomy, small bowel resection, incidental appendectomy. Presented with C/O oen day history of fever, abdominal pain with intermittent crying, vomiting and blood in stool. Fussiness and abdominal distension.


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