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This is VAERS ID 332276

(NOTE: This result is from the 12/31/2008 version of the VAERS database)

Case Details

VAERS ID: 332276 (history)  
Form: Version .0  
Age: 0.2  
Gender: Male  
Location: Missouri  
Vaccinated:2008-10-03
Onset:2008-10-26
   Days after vaccination:23
Submitted: 2008-11-13
   Days after onset:18
Entered: 2008-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHE: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B138BA / 0 UN / UN
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF450AB / 0 UN / UN
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC C86141 / 0 UN / UN
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CA691A / 0 - / PO

Administered by: Public       Purchased by: Unknown
Symptoms: Abdominal X-ray, Appendicectomy, Barium double contrast, Barium enema abnormal, Enema administration
SMQs:, Pseudomembranous colitis (broad), Ischaemic colitis (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No concurrent medication
Current Illness: Unknown
Preexisting Conditions: There was no history of adverse events following previous vaccinations as this was the subjects first set of vaccinations. PMH: none.
Allergies:
Diagnostic Lab Data: Unk. Labs and diagnostics: Air contrast enema (+) for IS in proximal transverse colon. Abd US (+) for ileocolic IS. Abd X-ray c/w bowel obstruction.
CDC Split Type:

Write-up: This case was reported by a healthcare professional and described the occurrence of intussusception in a 9-week-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). Concurrent vaccination included ACTHIB (Sanofi), PEDIARIX (GlaxoSmithKline)"and PREVENAR (Lederle) all given on 3 October 2008. There were no concurrent medications. On 3 October 2008 at 12:00 the subject received 1st dose of ROTARIX (oral). On 26 October 2008, 23 days after vaccination with ROTARIX, the subject experienced intus


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