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This is VAERS ID 322228

Case Details

VAERS ID: 322228 (history)  
Form: Version 1.0  
Age: 0.3  
Gender: Male  
Location: Foreign  
Vaccinated:2008-01-10
Onset:2008-01-14
   Days after vaccination:4
Submitted: 2008-08-14
   Days after onset:212
Entered: 2008-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 UN / IM
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 UN / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 UN / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 UN / IM
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 UN / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Abdominal X-ray, Abdominal pain, Appendicectomy, Barium double contrast, Haematemesis, Haematochezia, Inappropriate schedule of drug administration, Intussusception, Irritability, Mucous stools, Surgery, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Ischaemic colitis (broad), Medication errors (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: B0532764A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 4-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject had no history or family history of intussusception or bowel abnormalities. She had no congenital intestinal malformation or other gastrointestinal malformation and dysfunction. Previous and/or concurrent vaccination included the 1st dose of combined diphtheria, tetanus, acellular pertussis, inactivated poliomyelitis and Haemophilus influenzae type b vaccine (manufacturer unspecified; intramuscular0 given on 10 January 2008; 1st dose of hepatitis B vaccine recombinant (manufacturer unspecified; intramuscular) given on 10 January 2008; 1st dose of pneumococcal vaccine, unspecified (manufacturer unspecified; intramuscular) given on 10 January 2008 and a unique dose of tuberculosis vaccine (manufacturer unspecified; intradermal) given on 27 September 2007. On 10 January 2008, the subject received the 1st dose of ROTARIX (oral, lot number not provided). On 14 January 2008, 4 days after vaccination with the 1st dose of ROTARIX, the subject was admitted into the emergency room with one day of evolution with abdominal pain, a colic type, irritability, 2 times vomiting with gastric content and 4 evacuations with mucus and the last two with blood (seems like black currant jelly), he was giving initial diagnosis of intestinal intussusception. An abdominal X-ray was performed and was sentinel loop and abdominal distension and had it too clinically. Plain abdominal radiograph showed fluid levels and dilated bowel loops. Plain abdominal radiography did not show a visible intussusception or soft tissue mass. Invagination of the intestine was not demonstrated by air or liquid contrast enema. Plain abdominal radiograph did not show non-specific abnormalities. Abdominal ultrasound and abdominal CT were not performed. The physician considered the events were clinically significant (or requiring intervention). On 14 January 2008 intervention was decided; finding intussusception without referring the type, which remits by taxis without needing intestinal resection, no complications. An appendectomy was performed. The subject had good response and favorable evolution and he was discharged on 21 January 2008. On 21 January 2008, intussusception resolved. The physician considered the events were possibly related to vaccination with ROTARIX. Next vaccinations included the 2nd dose of ROTARIX (GlaxoSmithKline), the 2nd dose of combined diphtheria, tetanus, acellular pertussis, inactivated poliomyelitis and Haemophilus influenzae type b vaccine (manufacturer unspecified; intramuscular) given on 10 March 2008; the 2nd dose of hepatitis B vaccine recombinant (manufacturer unspecified; intramuscular) given on 10 March 2008 and the 2nd dose of pneumococcal vaccine, unspecified (manufacturer unspecified; intramuscular) given on 10 March 2008.


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