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This is VAERS ID 320743

Case Details

VAERS ID: 320743 (history)  
Form: Version 1.0  
Age: 0.2  
Gender: Female  
Location: Foreign  
Vaccinated:2008-01-09
Onset:2008-01-15
   Days after vaccination:6
Submitted: 2008-07-30
   Days after onset:196
Entered: 2008-07-29
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Abdominal X-ray, Intestinal obstruction, Intussusception, Ultrasound abdomen abnormal, Vomiting, X-ray abnormal
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Abdominal X-ray, Jan2008, IS; Ultrasound abdomen, Jan2008, IS
CDC Split Type: B0530263A

Write-up: This case was reported by a healthcare professional and described the occurrence of intussusception in a 2-month-old female subject who was vaccinated with ROTARIX. This case was collected through the Paediatric Surveillance Unit Acute Intussusception study occurring post Rotavirus vaccination. The subject was born at term. The subject''s birth weight is 3.315Kg. The subject had no family history of intussusception. Feeding history: The subject currently fed formula. The subject received no current treatment. The subject received other vaccines as per schedule. On 9 January 2008, the subject received the 1st dose of ROTARIX (unknown, lot number not provided). On 15 January 2008, 6 days after vaccination with the 1st dose of ROTARIX, the subject was admitted at hospital due to intussusception. The subject experienced intestinal obstruction, bile stained vomiting and vomiting. No faeces sample was collected. The diagnosis of intussusception was made based on abdominal ultrasound exam and abdominal X-ray. Intussusception had spontaneously reverted. At the time of reporting the outcome of the events was unspecified.


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