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This is VAERS ID 381865

Case Details

VAERS ID: 381865 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2010-03-04
Entered: 2010-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CA985A / UNK MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Abdominal pain, Intussusception, Screaming
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad)

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? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: B0635460A

Write-up: This case was reported by a physician via sales representative and described the occurrence of intussusception in a 3-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject was healthy before vaccination. On an unspecified date the subject received unspecified dose of ROTARIX (oral). 6 hours after vaccination with ROTARIX, the subject experienced intussusception of the gut. The pediatric who specialized in gastro felt the limb resolved in 2 hours. During that period the baby was screaming and suffered from severe abdominal pain. The baby wasn''t suffering from anything else and after 24 hours returned to normal. They were not intend to give her the second dose. This case was assessed as medically serious by GSK. At the time of reporting the events were resolved. No further information will follow because physician said the case was resolved.


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