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This is VAERS ID 845634

Case Details

VAERS ID: 845634 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2019-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RVX: ROTAVIRUS (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / OT

Administered by: Other       Purchased by: ?
Symptoms: Death, Intussusception
SMQs:, Gastrointestinal obstruction (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: BRGLAXOSMITHKLINEBR2019AM

Write-up: intussusception; This case was reported by a other health professional via sales rep and described the occurrence of intussusception in a child patient who received Rotavirus vaccine for prophylaxis. On an unknown date, the patient received Rotavirus vaccine (oral). On an unknown date, unknown after receiving Rotavirus vaccine, the patient experienced intussusception (serious criteria death and GSK medically significant). On an unknown date, the outcome of the intussusception was fatal. The reported cause of death was intussusception. It was unknown if the reporter considered the intussusception to be related to Rotavirus vaccine. Additional details were provided as follows: The age at vaccination was not reported. The patient was died, due to intussusception, after receiving the rotavirus vaccine. No additional information was provided.; Reported Cause(s) of Death: intussusception


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