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This is VAERS ID 335414

Case Details

VAERS ID: 335414 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Male  
Location: Foreign  
   Days after vaccination:7
Submitted: 2008-12-16
   Days after onset:10
Entered: 2008-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Abdominal mass, Colostomy, Haematochezia, Intensive care, Intestinal resection, Intussusception, Laparoscopy abnormal, Surgery
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 0 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: Laparoscopy, 08Dec2008, see text
CDC Split Type: B0549988A

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). On 29 November 2008, the subject received 1st dose of ROTARIX (oral). Lot number not provided. On 6 December 2008, 7 days after vaccination with ROTARIX, the subject started with blood streaked stools progressing to bloody stools. The patient was admitted on 6 December at ER. On 8 December 2008, exploratory laparoscopy was performed. Intussusception and abdominal mass were diagnosed. Intestine resection and colostomy were done. The subject was hospitalised and the physician considered the events were life threatening. At the time of reporting the events were improved, the subject was still at ICU. The physician considered the events were possibly related to vaccination with ROTARIX.

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