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This is VAERS ID 339377

(NOTE: This result is from the 12/8/2009 version of the VAERS database)

Case Details

VAERS ID: 339377 (history)  
Form: Version .0  
Age: 0.2  
Sex: Unknown  
Location: Foreign  
   Days after vaccination:1
Submitted: 2009-02-10
   Days after onset:30
Entered: 2009-02-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Decreased appetite, Intestinal perforation, Intestinal resection, Intussusception, Pain, Regurgitation, Surgery
SMQs:, Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal perforation (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Ischaemic colitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 0 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC Split Type: B0558583A

Write-up: This case was reported by a consumer and described the occurrence of regurgitation in a subject of unspecified age and gender who was vaccinated with ROTARIX (GlaxoSmithKline). A physician or other health care professional has not verified this report. On 10 January 2009 the subject received 1st dose of ROTARIX (oral). On 11 January 2009, 1 day after vaccination with ROTARIX, the subject experienced regurgitation and pain. On 13 January 2009 the regurgitations became yellow. On 14 January 2009 the regurgitations were more yellow and the subject did not eat in the evening. On 15 January 2009 the subject visited the emergency room and was hospitalised. A diagnosis of intussusception was made and the subject underwent surgery due to intestinal perforation. The subject was discharged from hospital on an unknown date. At the time of reporting the outcome of the events was unspecified. Verbatim text received: Her infant received a first dose of ROTARIX oral (batch unk) on 10 January 2009, administered by a foreign paediatrician. Then she went out of town (unspecified date). On 11 January 2009, the subject had more regurgitations than usual and pain. On 13 January 2009, yellow regurgitations. On 14 January 2009, regurgitations were more yellow. The subject did not eat in the evening. On 15 January 2009, went to emergency room + hospitalisation. Diagnosis of Intussusception and surgery due to perforation of intestine. Intestine resection. The subject has been discharged from hospital at an unspecified date. Past medical condition of the subject: no intussusception, no known intestine malformation, no constipation, no diarrhea. One hour after each bottle feed, the subject cried since birthdate. No family history of intestine malformation or intussusception.

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