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This is VAERS ID 311022

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 311022
VAERS Form:
Age:0.2
Gender:Female
Location:Foreign
Vaccinated:2008-01-23
Onset:0000-00-00
Submitted:2008-04-25
Entered:2008-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / ID
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / ID
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / ID
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - - / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Surgery

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0516402A

Write-up: This case was reported by a physician and described the occurrence of invagination of intestine in a 3-month-old female subject who was vaccinated with Rotarix (GlaxoSmithKline). The subject had no family history of intussusception or bowel abnormalities. The subject had no history of the following: congenital intestinal malformation, intestinal polyps, Merckel''s diverticulum, intestinal vascular malformations, cystic fibrosis, Hirschsprung disease, other gastrointestinal malformation and dysfunction. Previous vaccination included tuberculosis vaccine (manufacturer unspecified; oral) given on 18 November 2007. Concurrent vaccination included DTaP, HIB (manufacturer unspecified; intradermal; unknown) given on 23 January 2008 and hepatitis B vaccine recombinant (manufacturer unspecified; intramuscular; unknown) given on 23 January 2006. On 23 January 2008, the subject received the 1st dose of Rotarix (oral). On unspecified date, at unspecified time after vaccination with the 1st dose of Rotarix, the subject experienced intestinal invagination. On 29 February 2008, a reduction of intestinal invagination was performed in hospital and was without complications. The subject was discharged with good conditions; however she needed to go to the same hospital on 05 March 2008 with similar symptoms. The subject was hospitalised and the physician considered the event was clinically significant (or requiring intervention). Plain abdominal radiograph, abdominal ultrasound and abdominal CT were not performed. On 05 March 2008, the subject required again an intervention. Finding: interstinal invagination, corroborating on second surgery type colo-colic-cecolic, reduction was performed without complications. The subject did not have a bowel resection. The subject was transferred to another hospital on 10 March 2008 to continue with surveillance. The subject was stable, abdomen was tender and she was without evidence of post-surgery complications. She presented good oral tolerance, normal evacuations and she was without notice of


Changed on 5/13/2013

VAERS ID: 311022 Before After
VAERS Form:
Age:0.2
Gender:Female
Location:Foreign
Vaccinated:2008-01-23
Onset:0000-00-00
Submitted:2008-04-25
Entered:2008-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / ID
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / ID
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / ID
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - - / PO
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - - / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Surgery

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0516402A

Write-up: This case was reported by a physician and described the occurrence of invagination of intestine in a 3-month-old female subject who was vaccinated with Rotarix (GlaxoSmithKline). The subject had no family history of intussusception or bowel abnormalities. The subject had no history of the following: congenital intestinal malformation, intestinal polyps, Merckel''s diverticulum, intestinal vascular malformations, cystic fibrosis, Hirschsprung disease, other gastrointestinal malformation and dysfunction. Previous vaccination included tuberculosis vaccine (manufacturer unspecified; oral) given on 18 November 2007. Concurrent vaccination included DTaP, HIB (manufacturer unspecified; intradermal; unknown) given on 23 January 2008 and hepatitis B vaccine recombinant (manufacturer unspecified; intramuscular; unknown) given on 23 January 2006. On 23 January 2008, the subject received the 1st dose of Rotarix (oral). On unspecified date, at unspecified time after vaccination with the 1st dose of Rotarix, the subject experienced intestinal invagination. On 29 February 2008, a reduction of intestinal invagination was performed in hospital and was without complications. The subject was discharged with good conditions; however she needed to go to the same hospital on 05 March 2008 with similar symptoms. The subject was hospitalised and the physician considered the event was clinically significant (or requiring intervention). Plain abdominal radiograph, abdominal ultrasound and abdominal CT were not performed. On 05 March 2008, the subject required again an intervention. Finding: interstinal invagination, corroborating on second surgery type colo-colic-cecolic, reduction was performed without complications. The subject did not have a bowel resection. The subject was transferred to another hospital on 10 March 2008 to continue with surveillance. The subject was stable, abdomen was tender and she was without evidence of post-surgery complications. She presented good oral tolerance, normal evacuations and she was without notice of


Changed on 4/14/2017

VAERS ID: 311022 Before After
VAERS Form:
Age:0.2
Gender:Female
Location:Foreign
Vaccinated:2008-01-23
Onset:0000-00-00
Submitted:2008-04-25
Entered:2008-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / ID
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / ID
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / ID
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - - / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Surgery

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0516402A

Write-up: This case was reported by a physician and described the occurrence of invagination of intestine in a 3-month-old female subject who was vaccinated with Rotarix (GlaxoSmithKline). The subject had no family history of intussusception or bowel abnormalities. The subject had no history of the following: congenital intestinal malformation, intestinal polyps, Merckel''s diverticulum, intestinal vascular malformations, cystic fibrosis, Hirschsprung disease, other gastrointestinal malformation and dysfunction. Previous vaccination included tuberculosis vaccine (manufacturer unspecified; oral) given on 18 November 2007. Concurrent vaccination included DTaP, HIB (manufacturer unspecified; intradermal; unknown) given on 23 January 2008 and hepatitis B vaccine recombinant (manufacturer unspecified; intramuscular; unknown) given on 23 January 2006. On 23 January 2008, the subject received the 1st dose of Rotarix (oral). On unspecified date, at unspecified time after vaccination with the 1st dose of Rotarix, the subject experienced intestinal invagination. On 29 February 2008, a reduction of intestinal invagination was performed in hospital and was without complications. The subject was discharged with good conditions; however she needed to go to the same hospital on 05 March 2008 with similar symptoms. The subject was hospitalised and the physician considered the event was clinically significant (or requiring intervention). Plain abdominal radiograph, abdominal ultrasound and abdominal CT were not performed. On 05 March 2008, the subject required again an intervention. Finding: interstinal invagination, corroborating on second surgery type colo-colic-cecolic, reduction was performed without complications. The subject did not have a bowel resection. The subject was transferred to another hospital on 10 March 2008 to continue with surveillance. The subject was stable, abdomen was tender and she was without evidence of post-surgery complications. She presented good oral tolerance, normal evacuations and she was without notice of infection disease. She was discharged with good response on 12 March 2008. On 12 March 2008, the event was resolved. The physician considered the event was unrelated to vaccination with Rotarix.


Changed on 9/14/2017

VAERS ID: 311022 Before After
VAERS Form:(blank) 1
Age:0.2
Gender:Female
Location:Foreign
Vaccinated:2008-01-23
Onset:0000-00-00
Submitted:2008-04-25
Entered:2008-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK UN / ID
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK UN / ID
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK UN / ID
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - UNK - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Surgery

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0516402A

Write-up: This case was reported by a physician and described the occurrence of invagination of intestine in a 3-month-old female subject who was vaccinated with Rotarix (GlaxoSmithKline). The subject had no family history of intussusception or bowel abnormalities. The subject had no history of the following: congenital intestinal malformation, intestinal polyps, Merckel''s diverticulum, intestinal vascular malformations, cystic fibrosis, Hirschsprung disease, other gastrointestinal malformation and dysfunction. Previous vaccination included tuberculosis vaccine (manufacturer unspecified; oral) given on 18 November 2007. Concurrent vaccination included DTaP, HIB (manufacturer unspecified; intradermal; unknown) given on 23 January 2008 and hepatitis B vaccine recombinant (manufacturer unspecified; intramuscular; unknown) given on 23 January 2006. On 23 January 2008, the subject received the 1st dose of Rotarix (oral). On unspecified date, at unspecified time after vaccination with the 1st dose of Rotarix, the subject experienced intestinal invagination. On 29 February 2008, a reduction of intestinal invagination was performed in hospital and was without complications. The subject was discharged with good conditions; however she needed to go to the same hospital on 05 March 2008 with similar symptoms. The subject was hospitalised and the physician considered the event was clinically significant (or requiring intervention). Plain abdominal radiograph, abdominal ultrasound and abdominal CT were not performed. On 05 March 2008, the subject required again an intervention. Finding: interstinal invagination, corroborating on second surgery type colo-colic-cecolic, reduction was performed without complications. The subject did not have a bowel resection. The subject was transferred to another hospital on 10 March 2008 to continue with surveillance. The subject was stable, abdomen was tender and she was without evidence of post-surgery complications. She presented good oral tolerance, normal evacuations and she was without notice of infection disease. She was discharged with good response on 12 March 2008. On 12 March 2008, the event was resolved. The physician considered the event was unrelated to vaccination with Rotarix.


Changed on 2/14/2018

VAERS ID: 311022 Before After
VAERS Form:1
Age:0.2
Gender:Female
Location:Foreign
Vaccinated:2008-01-23
Onset:0000-00-00
Submitted:2008-04-25
Entered:2008-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / ID
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / ID
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / ID
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Surgery

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0516402A

Write-up: This case was reported by a physician and described the occurrence of invagination of intestine in a 3-month-old female subject who was vaccinated with Rotarix (GlaxoSmithKline). The subject had no family history of intussusception or bowel abnormalities. The subject had no history of the following: congenital intestinal malformation, intestinal polyps, Merckel''s diverticulum, intestinal vascular malformations, cystic fibrosis, Hirschsprung disease, other gastrointestinal malformation and dysfunction. Previous vaccination included tuberculosis vaccine (manufacturer unspecified; oral) given on 18 November 2007. Concurrent vaccination included DTaP, HIB (manufacturer unspecified; intradermal; unknown) given on 23 January 2008 and hepatitis B vaccine recombinant (manufacturer unspecified; intramuscular; unknown) given on 23 January 2006. On 23 January 2008, the subject received the 1st dose of Rotarix (oral). On unspecified date, at unspecified time after vaccination with the 1st dose of Rotarix, the subject experienced intestinal invagination. On 29 February 2008, a reduction of intestinal invagination was performed in hospital and was without complications. The subject was discharged with good conditions; however she needed to go to the same hospital on 05 March 2008 with similar symptoms. The subject was hospitalised and the physician considered the event was clinically significant (or requiring intervention). Plain abdominal radiograph, abdominal ultrasound and abdominal CT were not performed. On 05 March 2008, the subject required again an intervention. Finding: interstinal invagination, corroborating on second surgery type colo-colic-cecolic, reduction was performed without complications. The subject did not have a bowel resection. The subject was transferred to another hospital on 10 March 2008 to continue with surveillance. The subject was stable, abdomen was tender and she was without evidence of post-surgery complications. She presented good oral tolerance, normal evacuations and she was without notice of infection disease. She was discharged with good response on 12 March 2008. On 12 March 2008, the event was resolved. The physician considered the event was unrelated to vaccination with Rotarix.


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