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From the 6/14/2018 release of VAERS data (an older release, current is 1/7/2021):

This is VAERS ID 391673

Case Details

VAERS ID: 391673 (history)  
Form: Version 1.0  
Age: 0.33  
Sex: Male  
Location: Foreign  
   Days after vaccination:3
Submitted: 2010-06-29
   Days after onset:604
Entered: 2010-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Gastrointestinal necrosis, Intestinal resection, Intussusception, Laparotomy
SMQs:, Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal obstruction (narrow), Ischaemic colitis (narrow)

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? Yes, 0 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC Split Type: B0662814A

Write-up: This case was reported by a healthcare professional via another manufacturer (Fiocruz) and described the occurrence of intestinal necrosis in a 3-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). On 30 October 2008, the subject received 2nd dose of ROTARIX (oral). On 2 November 2008, 3 days after vaccination with ROTARIX, the subject experienced intussusception and intestine resection. 40 - 50 % of intestinal necrosis was removed. The subject was hospitalised and a laparotomy was performed. At the time of reporting the events were resolved. No further information could be obtained; the case has been closed.

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