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This is VAERS ID 330794

Case Details

VAERS ID: 330794 (history)  
Form: Version 1.0  
Age: 0.4  
Gender: Male  
Location: Foreign  
   Days after vaccination:27
Submitted: 2008-10-30
   Days after onset:28
Entered: 2008-10-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Abdominal X-ray, Abdominal pain, Barium double contrast, Blood culture, Blood electrolytes, Blood test, Crying, Flushing, Intussusception, Laboratory test, Oral intake reduced, Rectal haemorrhage, Surgery, X-ray abnormal
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (broad)

Life Threatening? Yes
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? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: Abdominal X-ray, 02Oct2008, Abnormal unit; Air contrast barium enema, 02Oct2008, Abnormal unit; Blood test, unknown; Serum electrolytes NOS, unknown
CDC Split Type: B0541544A

Write-up: This case was reported by a physician and described the occurrence of ileocolic intussusception in a 5-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). On 5 September 2008, the subject received 1st dose of ROTARIX (oral), lot number not provided. On 2 October 2008, 27 days after vaccination with ROTARIX, the subject experienced ileocolic intussusception. The event was confirmed by clinical features, abdomen x-ray and air contrast enema which showed an ileocolic intussusception. Surgery was performed without intestine resection. The physician considered the event was life threatening. The reporter considered the events were probably related to vaccination with ROTARIX. At the time of reporting the outcome of the events was unspecified. Follow up received on 23 October 2008: The signs and symptoms were decreased oral intake for 1 day along with excessive crying and periodic abdominal pain (the subject''s face became flushing during that episode and he pulled his legs) which lasted 2-3 minutes and got resolved by itself. The subject had 4-5 episodes of rectal bleeding (typical currant jelly color). Other relevant test included CP, serum electrolytes, blood C/S. The subject was treated with FLAGYL, AMPICILLIN, GENTAMYCIN and intravenous fluids. On 02 October 2008 surgical correction (manual reduction) was done. The subject''s condition improved and he was discharged on 07 October 2008 in OPD after 1 week.

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