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Found 565 cases where Vaccine is RV1 and Symptom is Intussusception and Appearance Date from '2008-02-01' to '2014-12-31'

Table

   
AgeCountPercent
< 3 Years55397.88%
3-6 Years10.18%
Unknown111.95%
TOTAL565100%

Case Details

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VAERS ID:331912 (history)  Vaccinated:2008-10-30
Age:0.5  Onset:2008-11-05, Days after vaccination: 6
Gender:Female  Submitted:2008-11-10, Days after onset: 5
Location:Oregon  Entered:2008-11-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none. PMH: none
Diagnostic Lab Data: KUB/contrast enemas. Labs and Diagnostics: Air contrast enema (+) for IS. Abd X-ray c/w IS. HCT 31.5. Hgb 10.4. Platelets 15.2K.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B192CA2IMLL
HIBV: HIB (ACTHIB)SANOFI PASTEURUF505AB2IMLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHUNKNOWN2IMRL
RV1: ROTAVIRUS (ROTARIX)GLAXOSMITHKLINE BIOLOGICALSA41FA692A0PO 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Enema administration, Intussusception, Surgery, Urinary system X-ray
SMQs:, Gastrointestinal obstruction (narrow)
Write-up: Intussusception - symptoms started 11/5/08; confirmed by x-ray on 11/6/08; unable to reduce by air contrast and barium contrast; required air transport to tertiary hospital and subsequent surgery. 11/18/2008 D/C Summary recieved for DOS 11/17-19/2008 with Final DX: Intussusception-ileocolic. Pt initially presented with pain, moaning, vomiting and blood streaked stool. Pt presented to hospital from another facility following failed reduction of IS via air contrast barium enema. Again, uanable to reduce so taken to OR for Laparoscopic reduction. Pt tolerated well, diet advance and d/c 11/9/08.

VAERS ID:332276 (history)  Vaccinated:2008-10-03
Age:0.2  Onset:2008-10-26, Days after vaccination: 23
Gender:Male  Submitted:2008-11-13, Days after onset: 18
Location:Missouri  Entered:2008-11-13
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: No concurrent medication
Current Illness: Unknown
Preexisting Conditions: There was no history of adverse events following previous vaccinations as this was the subjects first set of vaccinations. PMH: none.
Diagnostic Lab Data: Unk. Labs and diagnostics: Air contrast enema (+) for IS in proximal transverse colon. Abd US (+) for ileocolic IS. Abd X-ray c/w bowel obstruction.
CDC Split Type: A0755882A
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B138BA0UNUN
HIBV: HIB (ACTHIB)SANOFI PASTEURUF450AB0UNUN
PNC: PNEUMO (PREVNAR)PFIZER/WYETHC861410UNUN
RV1: ROTAVIRUS (ROTARIX)GLAXOSMITHKLINE BIOLOGICALSA41CA691A0PO 
Administered by: Public     Purchased by: Public
Symptoms: Abdominal X-ray, Appendicectomy, Barium double contrast, Barium enema abnormal, Enema administration, Hypophagia, Intussusception, Irritability, Large intestinal obstruction reduction, Melaena, Surgery, Ultrasound abdomen abnormal, Vomiting, X-ray abnormal
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Ischaemic colitis (broad), Hypoglycaemia (broad)
Write-up: This case was reported by a healthcare professional and described the occurrence of intussusception in a 9-week-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). Concurrent vaccination included ACTHIB (Sanofi), PEDIARIX (GlaxoSmithKline) and PREVENAR (Lederle) all given on 3 October 2008. There were no concurrent medications. On 3 October 2008 at 12:00 the subject received 1st dose of ROTARIX (oral). On 26 October 2008, 23 days after vaccination with ROTARIX, the subject experienced intussusception. The subject was hospitalised and the healthcare professional considered the event was disabling, life threatening and clinically significant (or requiring intervention). The subject was treated with unknown (Unknown treatment). On 6 November 2008, the event was resolved. The healthcare professional considered the event was probably related to vaccination with ROTARIX. 12/01/2008 MR received for DOS 10/26-30/2008 with D/C DX: Intussusception. Pt presented with 4 day hx of fussiness, intermittent emesis, tarry stool and poor po intake. IS noted on Abd US with attempted air enema reduction which was unsuccessful x 3. Taken to OR for an open reduction of IS, appendectomy and repair of serosal tears. initially NPO with PCA pain mgmt. Transitioned to oral diet and pain meds and d/c on POD#3.

VAERS ID:337673 (history)  Vaccinated:2008-11-18
Age:0.18  Onset:2009-01-07, Days after vaccination: 50
Gender:Female  Submitted:2009-01-14, Days after onset: 7
Location:Ohio  Entered:2009-01-20, Days after submission: 6
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None; Unknown
Preexisting Conditions: None; The subject has no medical or family history of intussusception or bowel abnormalities.
Diagnostic Lab Data: Ultrasound (+) intussusception with recurrence and surgical reduction. Secondary Payers patches. 1/21/09-records received-Underwent air enema reduction 3 times and had 4th recurrence which was documented by ultrasound. 2/2/09-records received-US showed recurrence of intussusception. Plain abdominal Radiography/Air or Liquid Contrast Enema: Demonstration of invagination of the intestine by air or liquid contrast enema.
CDC Split Type: A0762766A
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B186BA0IMRL
HIBV: HIB (ACTHIB)SANOFI PASTEURU7520AA0IMLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHC6830060IMLL
RV1: ROTAVIRUS (ROTARIX)GLAXOSMITHKLINE BIOLOGICALSA41FA691A0PO 
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain, Appendicectomy, Barium double contrast, Bowel movement irregularity, Explorative laparotomy, Haematochezia, Intussusception, Irritability, Occult blood positive, Screaming, Surgery, Ultrasound abdomen abnormal, Ultrasound scan abnormal, Vitello-intestinal duct remnant, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Retroperitoneal fibrosis (broad), Congenital, familial and genetic disorders (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Ischaemic colitis (broad), Noninfectious diarrhoea (broad), Hypoglycaemia (broad)
Write-up: Abd. pain, (+) Stool Guaiac, screaming with eating. Difficult to have BM. Intussusception - admitted 1/11/09 after reduction with air enema. (+) recurrence 1/13/09 with repeat air enema reduction, then surgery. 1/21/09-operative report received for DOS 1/15/09-presented with C/O ileocolic intussusception. Exploratory laparotomy. Findings: ileocolic intussusception secondary to hypertrophied Peyer''s patches in terminal ilieum. The intussusception reduced manually. Appendectomy. Resection Meckel diverticulum. 2/2/09-records received for DOS 1/11-1/17/09-DC DX: Inutssusception. Intussusception reduced on 1/11/09 by air contrast enema after bloody, jelly stool. Presented on 1/13/09 with C/O emesis, increased fussiness, abdominal irritation. US showed recurrence of intussusception. 2/2/09-records received for DOS 1/11-1/17/09-DC DX: Inutssusception. Intussusception reduced on 1/11/09 by air contrast enema after bloody, jelly stool. Presented on 1/13/09 with C/O emesis, increased fussiness, abdominal irritation. This case was reported by a physician via a sales representative and described the occurrence of intussusception in a 4-month-old subject of unspecified gender who was vaccinated with ROTARIX (GlaxoSmithKline). On an unspecified date the subject received 1st dose of ROTARIX (unknown). One month after vaccination with ROTARIX, the subject experienced intussusception. The subject required surgery and the adverse event resolved. The physician considered the event was clinically significant (or requiring intervention). The physician considered the events was possibly related to vaccination with ROTARIX. Follow-up information received on 26 February 2009 indicated that the subject was a 4 month old female. She received oral ROTARIX on 18 November 2008. Almost two months later, on 07 January 2009, symptoms began. A diagnosis of intussusception was made on 10 January 2009. The subject underwent surgical reduction with no resection on 15 January 2009. The event resolved on 17 January 2009. In addition to intervention, this case was considered to be serious as the event was life threatening and the subject was hospitalized. In the physician''s opinion, the events were possibly related to treatment with ROTARIX.

VAERS ID:341136 (history)  Vaccinated:2009-01-20
Age:0.2  Onset:2009-01-24, Days after vaccination: 4
Gender:Female  Submitted:2009-03-03, Days after onset: 38
Location:California  Entered:2009-03-05, Days after submission: 2
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: The subject had no concomitant medications.
Current Illness: Unknown
Preexisting Conditions: The subject had no concomitant medications, relevant medical history or adverse events following previous vaccinations. PMH: 32 wk premie
Diagnostic Lab Data: UNK. Labs and Diagnostics: Abd X-ray (+) for dilated bowel loops. BE (+) for persistant filling defect. Abd US c/w IS. Stool heme (+).
CDC Split Type: A0767773A
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC3000AA UNUN
RV1: ROTAVIRUS (ROTARIX)GLAXOSMITHKLINE BIOLOGICALSA41FA798A0PO 
Administered by: Private     Purchased by: Private
Symptoms: Abdominal X-ray, Abdominal distension, Appendicectomy, Barium enema abnormal, Enema administration, Explorative laparotomy, Haematochezia, Intussusception, Irritability, Large intestinal obstruction reduction, Lethargy, Occult blood positive, Ultrasound abdomen abnormal, Vomiting, X-ray abnormal
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Ischaemic colitis (broad), Hypoglycaemia (broad)
Write-up: This case was reported by a physician and described the occurrence of intussusception in a 3-month-old female subject who was vaccinated with ROTARIX. The subject had no concomitant medications, relevant medical history or adverse events following previous vaccinations. Previous and/or concurrent vaccination included DAPTACEL; Sanofi given on an 20 January 2009. On 20 January 2009 the subject received 1st dose of ROTARIX (1ml, oral). On 24 January 2009, 4 days after vaccination with ROTARIX, the subject experienced intussusception. It was attempted to resolve the intussusception with enemas twice and then the subject did have to undergo bowel surgery. The subject was in the hospital for four to five days and has since been released. The physician saw the subject on 02 February 2009 and stated that the subject was "recovering nicely". The physician did not think he will use ROTARIX again. The physician considered the event was disabling, life threatening and clinically significant (or requiring intervention). At the time of reporting the event was improved. The physician considered the event was probably related to vaccination with ROTARIX. 4/13/09 MR received for DOS 1/25-28/2009 with d/C DX: Intussusception of intestine. Pt presented with 2 day hx of emesis, bloody stool and lethargy with intermittent fussiness. PE (+) for abd distention. IS dx by US. Attempted reduction by BE only partially successful. Unable to fully reduce so pt to OR for Ex lap with reduction of IS and incidental appy. Improved on d/c.

VAERS ID:344235 (history)  Vaccinated:2009-03-31
Age:0.2  Onset:2009-04-13, Days after vaccination: 13
Gender:Female  Submitted:2009-04-15, Days after onset: 2
Location:New York  Entered:2009-04-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hospitalized 2/13/09; RSV; Bronchiolitis
Diagnostic Lab Data: Abdominal series; UGI; air contrast enema; exploratory surgery 5/14/09 hospital discharge summary recieved DOA 4/9/09-4/13/09. LABS and DIAGNOSTICS: Abdominal x-ray - dilated small bowel loops. Air contrast enema. CT scan of abdomen/pe
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B207AA0IMLL
HIBV: HIB (ACTHIB)SANOFI PASTEURUF513AA0IMRL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHD332450IMLL
RV1: ROTAVIRUS (ROTARIX)GLAXOSMITHKLINE BIOLOGICALSA41FA697A0PO 
Administered by: Private     Purchased by: Private
Symptoms: Abdominal X-ray, Abdominal distension, Anal haemorrhage, Computerised tomogram abdomen abnormal, Enema administration, Exploratory operation, Intussusception, Lethargy, Surgery, Vomiting, X-ray with contrast upper gastrointestinal tract
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Hypoglycaemia (broad)
Write-up: Pt. received vaccine 3/31/09. Presented with vomiting, lethargy on 4/14/09. Required surgery for Intussusception. 5/14/09 hospital discharge summary recieved DOA 4/9/09-4/13/09. FINAL DIAGNOSIS: Intussusception Post vaccination emesis, abdominal distention, lethargic, blood clots around anus.

VAERS ID:346278 (history)  Vaccinated:2009-04-03
Age:0.3  Onset:2009-05-10, Days after vaccination: 37
Gender:Female  Submitted:2009-05-13, Days after onset: 3
Location:South Carolina  Entered:2009-05-13
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: newborn jaundice
Diagnostic Lab Data: 6/15/09 Hospital records received DOS 5/12/09. LABS and DIAGNOSTICS: Reduction of intussusception with air contrast enema unsuccessful.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B207AA IMRL
HIBV: HIB (ACTHIB)SANOFI PASTEURUF595AA IMLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHC87338 IMLL
RV1: ROTAVIRUS (ROTARIX)GLAXOSMITHKLINE BIOLOGICALSA41FA697A PO 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abdominal mass, Abdominal pain, Barium double contrast, Bowel movement irregularity, Crying, Gastritis, Haematochezia, Intestinal resection, Intussusception, Irritability, Lethargy, Nasal congestion, Pyrexia, Rectal haemorrhage, Skin turgor decreased, Surgery, Tachycardia, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Ischaemic colitis (broad), Depression (excl suicide and self injury) (broad), Noninfectious diarrhoea (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Pt seen in hospital on May 11, 2009 with bilious emesis, and low grade fever. She was sent home with the diagnosis of acute gastritis. The patient presented to our clinic on Tuesday morning with same complaint and also report of no bowel movement for three days. When Dr. examined baby she had a palpable mass in her left lower abdomen. He then noted after examining her rectum, a grossly bloody stool. Patient was then sent to hospital where she was diagnosed with intussusception. She underwent bowel resection oon May 12, 2009. 6/15/09 Hospital records received DOS 5/12/09. Assessment: Intussusception. Patient presented with abdominal pain, bilious vomiting, crying, blood per rectum, bloody stool, fussy, lethargic. Congestion past 24hrs. Decreased skin turgidity. Tachycardia.6/22/09-ICD-9 codes received 560.0, 787.03. V 641. 9/28/09 Discharge summary received for date of service 5/12/09 to 5/17/09 DX: Successful surgical open reduction of the intussusception

VAERS ID:349618 (history)  Vaccinated:2009-05-27
Age:0.4  Onset:2009-06-04, Days after vaccination: 8
Gender:Male  Submitted:2009-06-19, Days after onset: 15
Location:Alabama  Entered:2009-06-19
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: The subject was completely healthy prior to vaccination. He had not experienced adverse events following prior vaccinations.
Diagnostic Lab Data: UNK. 7/9/09 Hospital records received DOS 6/5/09 to 6/7/09. LABS and DIAGNOSTICS: Hemoccult (+). X-ray Chest / Abdomen - multiple dilated loops of bowel. Abdominal Ultrasound - intussusception.
CDC Split Type: A0792059A
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL)SANOFI PASTEURC3230AA1UNLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHD370161UNLL
RV1: ROTAVIRUS (ROTARIX)GLAXOSMITHKLINE BIOLOGICALSA41SA697A1PO 
Administered by: Private     Purchased by: Public
Symptoms: Abdominal tenderness, Crying, Discomfort, Dry skin, Enema administration, Haematochezia, Hypophagia, Intussusception, Laparotomy, Large intestinal obstruction reduction, Lip dry, Listless, Occult blood positive, Restlessness, Screaming, Skin warm, Small intestinal intussusception reduction, Ultrasound abdomen abnormal, Vomiting, X-ray abnormal
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Akathisia (broad), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Ischaemic colitis (broad), Depression (excl suicide and self injury) (broad), Hypoglycaemia (broad)
Write-up: This case was reported by a physician, via a GSK representative and described the occurrence of intussusception in a 4-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject was completely healthy prior to vaccination. He had not experienced adverse events following prior vaccinations. Concurrent vaccinations included PENTACEL (non-GSK) (Sanofi) given on 27 May 2009; PREVNAR (Wyeth Labs) given on 27 May 2009. On 27 May 2009 the subject received 2nd dose of ROTARIX (1 ml, oral). The lot number was reported as "A41SA697A". On 4 June 2009, 8 days after vaccination with ROTARIX, the subject experienced intussusception. The subject was hospitalized for 4 days and the physician considered the event was disabling, life threatening and clinically significant (or requiring intervention). The subject was treated with intravenous fluids and barium enema. On 8 June 2009, the event was resolved. 7/9/09 Hospital records received DOS 6/5/09 to 6/7/09. Assessment: Intussusception. Patient presented with vomiting and has not tolerated any po intake. Prior ER visits. Restless, cries, screams. Appears uncomfortable, listless, abdomen tender to palpation, red stool noted during rectal exam. Dry lips. Skin warm, dry to touch. Air enema reduction of ileocolic intussusception. Subsequent exploratory laparoscopy and reduction of ileoileal intussusception ICD-9 Codes: 560.0 789.00, 789.07, 787.02, 792.1

VAERS ID:351299 (history)  Vaccinated:2009-05-28
Age:0.58  Onset:2009-06-15, Days after vaccination: 18
Gender:Female  Submitted:2009-07-07, Days after onset: 22
Location:South Carolina  Entered:2009-07-14, Days after submission: 7
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Well check up/constipation
Preexisting Conditions: None 12/10/09 Received medical records w/PMH: hernia repair. Allergies: NKDA
Diagnostic Lab Data: 12/10/09 Received medical records w/Labs: CBC, BMP, UA, Amylase, Lipase, Blood culture, no results noted, stools were guiac +. CXR norm, Air enema + for intussusception.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL)SANOFI PASTEURC3224AA2IMLL
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB736AA2IMRL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHD344382IMLL
RV1: ROTAVIRUS (ROTARIX)GLAXOSMITHKLINE BIOLOGICALSA41DA734A2PO 
Administered by: Private     Purchased by: Public
Symptoms: Barium double contrast, Blood amylase, Blood culture, Chest X-ray, Full blood count, Intussusception, Lethargy, Metabolic function test, Nausea, Occult blood positive, Pyrexia, Rectal haemorrhage, Surgery, Urine analysis, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Intussusception requiring surgical reduction. 12/10/2009 Received ED records for 6/16-6/18/2009, DC DX Intussusception which was successively reduced. ICD-9 560.0 patient with c/o''s nausea/vomiting, fever, lethargy, progressive sx x 3 days. Blood per rectum, Tx: IVF, IV ABX, Telemetry. Air enema partially reduced IS & patient transfered to higher level of care. Repeat air enema done.

VAERS ID:352902 (history)  Vaccinated:2009-07-24
Age:0.39  Onset:2009-07-30, Days after vaccination: 6
Gender:Male  Submitted:2009-07-31, Days after onset: 1
Location:New York  Entered:2009-07-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PMH: None Allergies: NKDA
Diagnostic Lab Data: KUB: findings which suggest an intussusception with the leading edge in the left transverse colon. The air in the right and transverse colon appears to have been displaced and there is what appears to be dilated small bowel in the right upper right quadrant of the abdomen. Air enema: ileo-colo-colic intussusception with satisfactory reduction. Labs none noted Dx studies: Xrays of abdomen + for intussusception, barium enem
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL)SANOFI PASTEURC3242AA0IMLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHD489271IMRL
RV1: ROTAVIRUS (ROTARIX)GLAXOSMITHKLINE BIOLOGICALSA41FA802A0PO 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Enema administration, Intussusception, Irritability, Urinary system X-ray, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal obstruction (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Hypoglycaemia (broad)
Write-up: intussusception 11/18/2009 ED record for 7/30-7/31/2009. DC DX Intussusception Patient with c/o''s irritability, vomiting. Xrays + for intussusception which was reduced per air enema. F/up xrays noted resolution. . ICD-9 code 560.0

VAERS ID:354607 (history)  Vaccinated:2009-07-08
Age:0.21  Onset:2009-07-15, Days after vaccination: 7
Gender:Female  Submitted:2009-08-05, Days after onset: 21
Location:New York  Entered:2009-08-07, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: There were no reported concomitant medications or relevant medical history. The subject had not experienced adverse events following previous vaccinations.
Diagnostic Lab Data: UNK. 10/2/09 Hospital records, DC summary, received DOS 7/16/09 to 7/17/09. LABS and DIAGNOSTICS: Ultrasound Abdomen Abnormal. CBC - WBC 14.6 (H) HCT 30.2% (L) MCV 91.1 (L) MCH 31.5 MMG (L) Platelets 454 THO/UL (H) Mono 16% (H) Atyp Lymph 2% (H). CHEM - CL 110 MEQ/L (H) Protein 5.5 GM/DL (L).
CDC Split Type: A0799191A
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC3084AA UNUN
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURB0476 UNUN
PNC: PNEUMO (PREVNAR)PFIZER/WYETHD4687U UNUN
RV1: ROTAVIRUS (ROTARIX)GLAXOSMITHKLINE BIOLOGICALSA41OA733A0PO 
Administered by: Private     Purchased by: Private
Symptoms: Abdominal rigidity, Ascites, Blood chloride decreased, Dehydration, Faecal volume decreased, Haematocrit decreased, Heart rate increased, Intussusception, Irritability, Lymphocyte morphology abnormal, Mean cell haemoglobin decreased, Mean cell volume decreased, Monocyte percentage increased, Platelet count increased, Protein total decreased, Pyrexia, Rash, Respiratory rate increased, Ultrasound abdomen abnormal, Urine output decreased, Vomiting, White blood cell count increased
SMQs:, Acute renal failure (broad), Liver related investigations, signs and symptoms (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haematopoietic erythropenia (broad), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Gastrointestinal obstruction (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Hypersensitivity (narrow), Malignant lymphomas (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad)
Write-up: This case was reported by a healthcare professional and described the occurrence of intussusception in a 2-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). There were no reported concomitant medications or relevant medical history. The subject had not experienced adverse events following previous vaccinations. Concurrent vaccination included DAPTACEL (non-gsk) (Sanofi) given on 8 July 2009; PREVNAR (non-gsk) (Wyeth Labs) given on 8 July 2009; IPOL (non-gsk) (Sanofi) given on 8 July 2009. On 8 July 2009 the subject received 1st dose of ROTARIX (1 ml; oral). The lot number was reported as A41OA733A. On 15 July 2009, 7 days after vaccination with ROTARIX, the subject experienced intussusception and "severe" vomiting. The subject was hospitalised and the healthcare professional considered the events were clinically significant (or requiring intervention). At the time of reporting the events were improved. The healthcare professional considered the events were probably related to vaccination with ROTARIX. 10/2/09 Hospital records, DC summary, received DOS 7/16/09 to 7/17/09. Assessment: Intussusception. Presented to ER with 2 days of increased vomiting, fussiness, and decreased stooling, no wet diapers. Fever, respirations and heart rate elevated. Rash below chin. Abdomen rigid. Symptoms resolved with air enema. Some ascites. ICD-9 Codes: 560.0 Intussusception, 276.51 Dehydration. Follow-up information received on 21 August 2009 indicated that the events began on 15 July 2009 and resolving by the following day, 16 July 2009. The subject received an enema for treatment and symptoms resolved. In the reporter''s opinion, the events were probably related to treatment with ROTARIX. The child did not receive bowel resection.

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