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This is VAERS ID 335711

Case Details

VAERS ID: 335711 (history)  
Form: Version 1.0  
Age: 0.3  
Gender: Male  
Location: Foreign  
Vaccinated:2008-12-05
Onset:2008-12-10
   Days after vaccination:5
Submitted: 2008-12-19
   Days after onset:9
Entered: 2008-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Barium double contrast, Gastrointestinal disorder, Intussusception, X-ray abnormal
SMQs:, Gastrointestinal obstruction (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 11Dec2008, Abnormal
CDC Split Type: B0550536A

Write-up: This case was reported by a consumer and described the occurrence of intussusception in a 3-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). A physician or other health care professional has not verified this report. On 5 December 2008, the subject received 1st dose of ROTARIX (oral), lot number not provided. On 10 December 2008, 5 days after vaccination with ROTARIX, the subject experienced intussusception. On 11 December 2008, the subject was hospitalised. Abdomen X-ray was performed twice and revealed intestinal swelling. The subject was transferred to another hospital on 13 December 2008 where he was treated with air enema. The subject was hospitalised for 5 days. On 15 December 2008, the events were resolved and the subject was discharged from hospital.


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