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This is VAERS ID 322636

Case Details

VAERS ID: 322636 (history)  
Form: Version 1.0  
Age: 0.3  
Gender: Female  
Location: Foreign  
Vaccinated:2008-07-14
Onset:2008-07-17
   Days after vaccination:3
Submitted: 2008-08-19
   Days after onset:33
Entered: 2008-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Colectomy, Enema administration, Intestinal operation, Intussusception, Surgery
SMQs:, Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal obstruction (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
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: UNK
CDC Split Type: D0058386A

Write-up: This case was reported by an unknown physician via a regulatory authority and described the occurrence of invagination of intestine in a 3-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). It was unknown whether or not the subject experienced any adverse event post previous vaccination(s). On 14 July 2008 the subject received an unspecified dose of ROTARIX (0.5 ml, oral). Approximately three days post vaccination with ROTARIX, on 17 July 2008, the subject experienced invagination of intestine. The subject was hospitalised for an unknown period of time. The reporting physician considered that the event was life threatening. Treatment included hydrostatic disinvagination on 17 July 2008 without success. On 18 July 2008 the subject underwent bowel surgery. The reporting physician considered undesirable vaccination adverse reaction. At the time of reporting, on 08 August 2008, the events were resolved with the following sequelae (state post surgery). No further information will be available.


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