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This is VAERS ID 309282

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 309282
VAERS Form:
Age:0.5
Gender:Male
Location:Foreign
Vaccinated:2007-07-25
Onset:2007-10-27
Submitted:2008-04-10
Entered:2008-04-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal mass, Abdominal tenderness, Abnormal faeces, Barium double contrast, Crying, Faeces discoloured, Haematochezia, Haematocrit normal, Haemoglobin decreased, Intussusception, Pallor, Vomiting, White blood cell count increased, Enema administration, Platelet count increased, Ultrasound abdomen abnormal, Neutrophil percentage, Lymphocyte percentage, Abdominal X-ray

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 28Oct2007, No data; Hematocrit, 28Oct2007, 35.8%; Hemoglobin, 28Oct2007, 11.9g/dL; Lymphocyte percentage, 28Oct2007, 27%; Neutrophil percentage, 28Oct2007, 64.2%; Platelet count, 28Oct2007, 530000/mm3; Ultrasound abdomen, 2
CDC 'Split Type': B0514821A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 9-month-old male subject who was vaccinated with Rotarix (GlaxoSmithKline). The subject had no relevant medical history or allergies. The subject had no concomitant medication. Previous vaccination included Rotarix (GlaxoSmithKline; oral) given on 23 March 2007. On 25 July 2007, the subject received the 2nd dose of Rotarix (oral). On 27 October 2007, 94 days after vaccination with the 2nd dose of Rotarix, the subject experienced repeated vomiting (30/24h), continuous crying and a jelly red stool. The subject was taken to the emergency room. Physical exam reported mild pallor, abdominal tenderness with a mass in the upper left quadrant. The subject was hospitalised. Laboratory tests performed on 28 October 2007 and showed the following: Hemoglobin: 11.9 g/dL (normal range: 12.2-18.1); Hematocrit: 35.8% (normal range: 37.7-53.7); Leucocytes: 16500/mm3 (normal range: 4600-10200); Neutrophils: 64.2% (normal range: 37-80); Lymphocytes: 27% (normal range: 10-50); Platelets count: 530000/mm3 (normal range: 142000-424000). Abdominal X-ray was performed but showed no specific data. Abdominal ultrasound was performed and showed intussusception. On 28 October 2007, pneumoenema with 90mmHg pressure was performed and intussusception was resolved. The subject was treated with amikacin, metronidazole, Metamizol, Ranitidine, omeprazole and Ketorolaco. The subject evolved to clinical improvement and he was discharged on 30 October 2007 in good clinical conditions. On 30 October 2007, the events were resolved. The physician considered the events were unrelated to vaccination with Rotarix.


Changed on 5/13/2013

VAERS ID: 309282 Before After
VAERS Form:
Age:0.5
Gender:Male
Location:Foreign
Vaccinated:2007-07-25
Onset:2007-10-27
Submitted:2008-04-10
Entered:2008-04-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 - / PO
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal mass, Abdominal tenderness, Abnormal faeces, Barium double contrast, Crying, Faeces discoloured, Haematochezia, Haematocrit normal, Haemoglobin decreased, Intussusception, Pallor, Vomiting, White blood cell count increased, Enema administration, Platelet count increased, Ultrasound abdomen abnormal, Neutrophil percentage, Lymphocyte percentage, Abdominal X-ray

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 28Oct2007, No data; Hematocrit, 28Oct2007, 35.8%; Hemoglobin, 28Oct2007, 11.9g/dL; Lymphocyte percentage, 28Oct2007, 27%; Neutrophil percentage, 28Oct2007, 64.2%; Platelet count, 28Oct2007, 530000/mm3; Ultrasound abdomen, 2
CDC 'Split Type': B0514821A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 9-month-old male subject who was vaccinated with Rotarix (GlaxoSmithKline). The subject had no relevant medical history or allergies. The subject had no concomitant medication. Previous vaccination included Rotarix (GlaxoSmithKline; oral) given on 23 March 2007. On 25 July 2007, the subject received the 2nd dose of Rotarix (oral). On 27 October 2007, 94 days after vaccination with the 2nd dose of Rotarix, the subject experienced repeated vomiting (30/24h), continuous crying and a jelly red stool. The subject was taken to the emergency room. Physical exam reported mild pallor, abdominal tenderness with a mass in the upper left quadrant. The subject was hospitalised. Laboratory tests performed on 28 October 2007 and showed the following: Hemoglobin: 11.9 g/dL (normal range: 12.2-18.1); Hematocrit: 35.8% (normal range: 37.7-53.7); Leucocytes: 16500/mm3 (normal range: 4600-10200); Neutrophils: 64.2% (normal range: 37-80); Lymphocytes: 27% (normal range: 10-50); Platelets count: 530000/mm3 (normal range: 142000-424000). Abdominal X-ray was performed but showed no specific data. Abdominal ultrasound was performed and showed intussusception. On 28 October 2007, pneumoenema with 90mmHg pressure was performed and intussusception was resolved. The subject was treated with amikacin, metronidazole, Metamizol, Ranitidine, omeprazole and Ketorolaco. The subject evolved to clinical improvement and he was discharged on 30 October 2007 in good clinical conditions. On 30 October 2007, the events were resolved. The physician considered the events were unrelated to vaccination with Rotarix.


Changed on 4/14/2017

VAERS ID: 309282 Before After
VAERS Form:
Age:0.5
Gender:Male
Location:Foreign
Vaccinated:2007-07-25
Onset:2007-10-27
Submitted:2008-04-10
Entered:2008-04-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal mass, Abdominal tenderness, Abnormal faeces, Barium double contrast, Crying, Faeces discoloured, Haematochezia, Haematocrit normal, Haemoglobin decreased, Intussusception, Pallor, Vomiting, White blood cell count increased, Enema administration, Platelet count increased, Ultrasound abdomen abnormal, Neutrophil percentage, Lymphocyte percentage, Abdominal X-ray

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 28Oct2007, No data; Hematocrit, 28Oct2007, 35.8%; Hemoglobin, 28Oct2007, 11.9g/dL; Lymphocyte percentage, 28Oct2007, 27%; Neutrophil percentage, 28Oct2007, 64.2%; Platelet count, 28Oct2007, 530000/mm3; Ultrasound abdomen, 2 28Oct2007, IS confirmed; White blood cell count, 28Oct2007, 16500/mm3
CDC 'Split Type': B0514821A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 9-month-old male subject who was vaccinated with Rotarix (GlaxoSmithKline). The subject had no relevant medical history or allergies. The subject had no concomitant medication. Previous vaccination included Rotarix (GlaxoSmithKline; oral) given on 23 March 2007. On 25 July 2007, the subject received the 2nd dose of Rotarix (oral). On 27 October 2007, 94 days after vaccination with the 2nd dose of Rotarix, the subject experienced repeated vomiting (30/24h), continuous crying and a jelly red stool. The subject was taken to the emergency room. Physical exam reported mild pallor, abdominal tenderness with a mass in the upper left quadrant. The subject was hospitalised. Laboratory tests performed on 28 October 2007 and showed the following: Hemoglobin: 11.9 g/dL (normal range: 12.2-18.1); Hematocrit: 35.8% (normal range: 37.7-53.7); Leucocytes: 16500/mm3 (normal range: 4600-10200); Neutrophils: 64.2% (normal range: 37-80); Lymphocytes: 27% (normal range: 10-50); Platelets count: 530000/mm3 (normal range: 142000-424000). Abdominal X-ray was performed but showed no specific data. Abdominal ultrasound was performed and showed intussusception. On 28 October 2007, pneumoenema with 90mmHg pressure was performed and intussusception was resolved. The subject was treated with amikacin, metronidazole, Metamizol, Ranitidine, omeprazole and Ketorolaco. The subject evolved to clinical improvement and he was discharged on 30 October 2007 in good clinical conditions. On 30 October 2007, the events were resolved. The physician considered the events were unrelated to vaccination with Rotarix.


Changed on 9/14/2017

VAERS ID: 309282 Before After
VAERS Form:(blank) 1
Age:0.5
Gender:Male
Location:Foreign
Vaccinated:2007-07-25
Onset:2007-10-27
Submitted:2008-04-10
Entered:2008-04-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 2 - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal mass, Abdominal tenderness, Abnormal faeces, Barium double contrast, Crying, Faeces discoloured, Haematochezia, Haematocrit normal, Haemoglobin decreased, Intussusception, Pallor, Vomiting, White blood cell count increased, Enema administration, Platelet count increased, Ultrasound abdomen abnormal, Neutrophil percentage, Lymphocyte percentage, Abdominal X-ray

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 28Oct2007, No data; Hematocrit, 28Oct2007, 35.8%; Hemoglobin, 28Oct2007, 11.9g/dL; Lymphocyte percentage, 28Oct2007, 27%; Neutrophil percentage, 28Oct2007, 64.2%; Platelet count, 28Oct2007, 530000/mm3; Ultrasound abdomen, 28Oct2007, IS confirmed; White blood cell count, 28Oct2007, 16500/mm3
CDC 'Split Type': B0514821A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 9-month-old male subject who was vaccinated with Rotarix (GlaxoSmithKline). The subject had no relevant medical history or allergies. The subject had no concomitant medication. Previous vaccination included Rotarix (GlaxoSmithKline; oral) given on 23 March 2007. On 25 July 2007, the subject received the 2nd dose of Rotarix (oral). On 27 October 2007, 94 days after vaccination with the 2nd dose of Rotarix, the subject experienced repeated vomiting (30/24h), continuous crying and a jelly red stool. The subject was taken to the emergency room. Physical exam reported mild pallor, abdominal tenderness with a mass in the upper left quadrant. The subject was hospitalised. Laboratory tests performed on 28 October 2007 and showed the following: Hemoglobin: 11.9 g/dL (normal range: 12.2-18.1); Hematocrit: 35.8% (normal range: 37.7-53.7); Leucocytes: 16500/mm3 (normal range: 4600-10200); Neutrophils: 64.2% (normal range: 37-80); Lymphocytes: 27% (normal range: 10-50); Platelets count: 530000/mm3 (normal range: 142000-424000). Abdominal X-ray was performed but showed no specific data. Abdominal ultrasound was performed and showed intussusception. On 28 October 2007, pneumoenema with 90mmHg pressure was performed and intussusception was resolved. The subject was treated with amikacin, metronidazole, Metamizol, Ranitidine, omeprazole and Ketorolaco. The subject evolved to clinical improvement and he was discharged on 30 October 2007 in good clinical conditions. On 30 October 2007, the events were resolved. The physician considered the events were unrelated to vaccination with Rotarix.


Changed on 2/14/2018

VAERS ID: 309282 Before After
VAERS Form:1
Age:0.5
Gender:Male
Location:Foreign
Vaccinated:2007-07-25
Onset:2007-10-27
Submitted:2008-04-10
Entered:2008-04-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 2 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal mass, Abdominal tenderness, Abnormal faeces, Barium double contrast, Crying, Faeces discoloured, Haematochezia, Haematocrit normal, Haemoglobin decreased, Intussusception, Pallor, Vomiting, White blood cell count increased, Enema administration, Platelet count increased, Ultrasound abdomen abnormal, Neutrophil percentage, Lymphocyte percentage, Abdominal X-ray

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 28Oct2007, No data; Hematocrit, 28Oct2007, 35.8%; Hemoglobin, 28Oct2007, 11.9g/dL; Lymphocyte percentage, 28Oct2007, 27%; Neutrophil percentage, 28Oct2007, 64.2%; Platelet count, 28Oct2007, 530000/mm3; Ultrasound abdomen, 28Oct2007, IS confirmed; White blood cell count, 28Oct2007, 16500/mm3
CDC 'Split Type': B0514821A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 9-month-old male subject who was vaccinated with Rotarix (GlaxoSmithKline). The subject had no relevant medical history or allergies. The subject had no concomitant medication. Previous vaccination included Rotarix (GlaxoSmithKline; oral) given on 23 March 2007. On 25 July 2007, the subject received the 2nd dose of Rotarix (oral). On 27 October 2007, 94 days after vaccination with the 2nd dose of Rotarix, the subject experienced repeated vomiting (30/24h), continuous crying and a jelly red stool. The subject was taken to the emergency room. Physical exam reported mild pallor, abdominal tenderness with a mass in the upper left quadrant. The subject was hospitalised. Laboratory tests performed on 28 October 2007 and showed the following: Hemoglobin: 11.9 g/dL (normal range: 12.2-18.1); Hematocrit: 35.8% (normal range: 37.7-53.7); Leucocytes: 16500/mm3 (normal range: 4600-10200); Neutrophils: 64.2% (normal range: 37-80); Lymphocytes: 27% (normal range: 10-50); Platelets count: 530000/mm3 (normal range: 142000-424000). Abdominal X-ray was performed but showed no specific data. Abdominal ultrasound was performed and showed intussusception. On 28 October 2007, pneumoenema with 90mmHg pressure was performed and intussusception was resolved. The subject was treated with amikacin, metronidazole, Metamizol, Ranitidine, omeprazole and Ketorolaco. The subject evolved to clinical improvement and he was discharged on 30 October 2007 in good clinical conditions. On 30 October 2007, the events were resolved. The physician considered the events were unrelated to vaccination with Rotarix.


Changed on 6/14/2018

VAERS ID: 309282 Before After
VAERS Form:1
Age:0.5
Gender:Male
Location:Foreign
Vaccinated:2007-07-25
Onset:2007-10-27
Submitted:2008-04-10
Entered:2008-04-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 2 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal mass, Abdominal tenderness, Abnormal faeces, Barium double contrast, Crying, Faeces discoloured, Haematochezia, Haematocrit normal, Haemoglobin decreased, Intussusception, Pallor, Vomiting, White blood cell count increased, Enema administration, Platelet count increased, Ultrasound abdomen abnormal, Neutrophil percentage, Lymphocyte percentage, Abdominal X-ray

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 28Oct2007, No data; Hematocrit, 28Oct2007, 35.8%; Hemoglobin, 28Oct2007, 11.9g/dL; Lymphocyte percentage, 28Oct2007, 27%; Neutrophil percentage, 28Oct2007, 64.2%; Platelet count, 28Oct2007, 530000/mm3; Ultrasound abdomen, 28Oct2007, IS confirmed; White blood cell count, 28Oct2007, 16500/mm3
CDC 'Split Type': B0514821A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 9-month-old male subject who was vaccinated with Rotarix (GlaxoSmithKline). The subject had no relevant medical history or allergies. The subject had no concomitant medication. Previous vaccination included Rotarix (GlaxoSmithKline; oral) given on 23 March 2007. On 25 July 2007, the subject received the 2nd dose of Rotarix (oral). On 27 October 2007, 94 days after vaccination with the 2nd dose of Rotarix, the subject experienced repeated vomiting (30/24h), continuous crying and a jelly red stool. The subject was taken to the emergency room. Physical exam reported mild pallor, abdominal tenderness with a mass in the upper left quadrant. The subject was hospitalised. Laboratory tests performed on 28 October 2007 and showed the following: Hemoglobin: 11.9 g/dL (normal range: 12.2-18.1); Hematocrit: 35.8% (normal range: 37.7-53.7); Leucocytes: 16500/mm3 (normal range: 4600-10200); Neutrophils: 64.2% (normal range: 37-80); Lymphocytes: 27% (normal range: 10-50); Platelets count: 530000/mm3 (normal range: 142000-424000). Abdominal X-ray was performed but showed no specific data. Abdominal ultrasound was performed and showed intussusception. On 28 October 2007, pneumoenema with 90mmHg pressure was performed and intussusception was resolved. The subject was treated with amikacin, metronidazole, Metamizol, Ranitidine, omeprazole and Ketorolaco. The subject evolved to clinical improvement and he was discharged on 30 October 2007 in good clinical conditions. On 30 October 2007, the events were resolved. The physician considered the events were unrelated to vaccination with Rotarix.

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