National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 380640

Case Details

VAERS ID: 380640 (history)  
Form: Version 1.0  
Age: 0.19  
Sex: Female  
Location: Foreign  
Vaccinated:2008-12-08
Onset:2009-01-19
   Days after vaccination:42
Submitted: 2010-02-17
   Days after onset:394
Entered: 2010-02-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Abdominal X-ray, Abdominal mass, Cardiomegaly, Cyanosis, Gastrointestinal hypermotility, Haematochezia, Intussusception, Irritability, Laparotomy, Lung infiltration, Nausea, Pallor, Pneumonia, Respiratory disorder, Vomiting, X-ray abnormal
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Interstitial lung disease (narrow), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific dysfunction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Ischaemic colitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Noninfectious diarrhoea (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: HEALTHY BABY
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: abdominal x-ray, 20Jan2009, see text.
CDC Split Type: B0633713A

Write-up: This case was reported by a physician and described the occurrence of ileocolic intussusception in a 3-month-old female subject who was vaccinated with ROTARIX (Glaxosmithkline). Previous and/or concurrent vaccination included PNEUMOCOCCAL vaccine; non-gsk manufacturer; intramuscular given on 8 December 2008; bacillus calmette-guerin vaccine (non-gsk); non gsk manufacturer; intradermal given on 28 September 2008; HEPATITIS B vaccine recombinant; manufacturer unspecified; intramuscular given on 28 September 2008 and 8 December 2008. The subject''s medical conditions included a healthy baby. On 8 December 2008 the subject received 1st dose of ROTARIX (oral). On 19 January 2009, 42 days after vaccination with ROTARIX, the subject experienced cyanosis, nausea and vomiting. The subject was brought to the emergency room. On 20 January 2009 she presented pallor irritability, increased of peristalsis, respiratory problems, blood stools, palpable abdominal mass. On 21 January 2009 the abdominal x-ray revealed pneumonic infiltration and cardiomegaly. Ileocolic intussusception was suspected and after confirmed. On 21 January underwent a laparotomy (no bowel resection was needed). Furthermore the subject was diagnosed with pneumonia and treated with ampicillin and furosemide without complications. On 24 January 2009 the subject was discharged in good medical conditions. The subject was hospitalized and the physician considered the events were clinically significant (or requiring intervention). The physician considered the events were almost certainly related to vaccination with ROTARIX.


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=380640


Copyright © 2019 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166