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This is VAERS ID 389605

Case Details

VAERS ID: 389605 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Unknown  
Location: Foreign  
Vaccinated:0000-00-00
Onset:2010-03-01
Submitted: 2010-05-28
   Days after onset:87
Entered: 2010-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Intussusception, Lymphadenitis
SMQs:, Gastrointestinal obstruction (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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, 0 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: B0657046A

Write-up: This case was reported by a consumer and described the occurrence of invagination of intestine in a 3-month-old subject of unspecified gender who was vaccinated with ROTARIX (GlaxoSmithKline). A physician or other health care professional has not verified this report. In 2010, the subject received unspecified dose of ROTARIX (route unknown, batch number not provided). 2 days after vaccination with ROTARIX, the child was ok. In March 2010, 4 days after vaccination with ROTARIX, the subject experienced invagination of intestine and mesenteric lymphadenitis. The subject was hospitalised. At the time of reporting, the outcome of the events was unspecified. No further information is available because the subject changed his treating pediatrician.


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