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This is VAERS ID 384493

Case Details

VAERS ID: 384493 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Male  
Location: Foreign  
   Days after vaccination:5
Submitted: 2010-04-07
   Days after onset:1082
Entered: 2010-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Haematochezia, Intussusception, Mucous stools, No reaction on previous exposure to drug, Surgery, Ultrasound scan abnormal, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: Ultrasound scan, Apr2007, intussusception
CDC Split Type: B0645476A

Write-up: This case was reported by the regulatory authority (reference NY20070053) and described the occurrence of intussusception of intestine in a 3-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). Medical conditions and concurrent medications were unspecified. Previous vaccination included a first dose of ROTARIX given on 13 March 2007, well tolerated. On 16 April 2007, the subject received a 2nd dose of ROTARIX (batch unknown, oral). On 21 April 2007, five days after vaccination with ROTARIX, the subject was hospitalized for vomiting, bloody and mucous stools without abdominal pain. As vomiting were persisting, an abdominal ultrasound scan was performed and revealed acute intussusception of intestine. Clinical course was favorable after surgery. On 23 April 2007, after three days of hospitalisation, the subject was discharged from hospital. At the time of reporting, intussusception of intestine was improved and other events were resolved. According to the method of assessment, the relationship between vaccination with ROTARIX and the reported events was dubious.

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