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This is VAERS ID 311333

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 311333
VAERS Form:
Age:0.4
Gender:Female
Location:Foreign
Vaccinated:2008-04-10
Onset:2008-04-16
Submitted:2008-04-30
Entered:2008-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal distension, Intestinal obstruction, Intussusception, Surgery, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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': B0517644A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 5-month-old female subject who was vaccinated with Rotarix (GlaxoSmithKline). No concomitant medication was given to the subject. On 10 April 2008, the subject received unspecified dose of Rotarix (oral), lot number not provided. On 16 April 2008, 6 days after vaccination with Rotarix, the subject experienced abdominal distension and vomiting. On 18 April 2008, the subject was hospitalised. The exam performed showed intestinal obstruction. A surgery was performed and intussusception was found. The physician considered the events were life threatening and clinically significant (or requiring intervention). At the time of reporting the events were improved.


Changed on 5/13/2013

VAERS ID: 311333 Before After
VAERS Form:
Age:0.4
Gender:Female
Location:Foreign
Vaccinated:2008-04-10
Onset:2008-04-16
Submitted:2008-04-30
Entered:2008-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - - / PO
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal distension, Intestinal obstruction, Intussusception, Surgery, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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': B0517644A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 5-month-old female subject who was vaccinated with Rotarix (GlaxoSmithKline). No concomitant medication was given to the subject. On 10 April 2008, the subject received unspecified dose of Rotarix (oral), lot number not provided. On 16 April 2008, 6 days after vaccination with Rotarix, the subject experienced abdominal distension and vomiting. On 18 April 2008, the subject was hospitalised. The exam performed showed intestinal obstruction. A surgery was performed and intussusception was found. The physician considered the events were life threatening and clinically significant (or requiring intervention). At the time of reporting the events were improved.


Changed on 9/14/2017

VAERS ID: 311333 Before After
VAERS Form:(blank) 1
Age:0.4
Gender:Female
Location:Foreign
Vaccinated:2008-04-10
Onset:2008-04-16
Submitted:2008-04-30
Entered:2008-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - UNK - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal distension, Intestinal obstruction, Intussusception, Surgery, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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': B0517644A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 5-month-old female subject who was vaccinated with Rotarix (GlaxoSmithKline). No concomitant medication was given to the subject. On 10 April 2008, the subject received unspecified dose of Rotarix (oral), lot number not provided. On 16 April 2008, 6 days after vaccination with Rotarix, the subject experienced abdominal distension and vomiting. On 18 April 2008, the subject was hospitalised. The exam performed showed intestinal obstruction. A surgery was performed and intussusception was found. The physician considered the events were life threatening and clinically significant (or requiring intervention). At the time of reporting the events were improved.


Changed on 2/14/2018

VAERS ID: 311333 Before After
VAERS Form:1
Age:0.4
Gender:Female
Location:Foreign
Vaccinated:2008-04-10
Onset:2008-04-16
Submitted:2008-04-30
Entered:2008-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal distension, Intestinal obstruction, Intussusception, Surgery, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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': B0517644A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 5-month-old female subject who was vaccinated with Rotarix (GlaxoSmithKline). No concomitant medication was given to the subject. On 10 April 2008, the subject received unspecified dose of Rotarix (oral), lot number not provided. On 16 April 2008, 6 days after vaccination with Rotarix, the subject experienced abdominal distension and vomiting. On 18 April 2008, the subject was hospitalised. The exam performed showed intestinal obstruction. A surgery was performed and intussusception was found. The physician considered the events were life threatening and clinically significant (or requiring intervention). At the time of reporting the events were improved.


Changed on 6/14/2018

VAERS ID: 311333 Before After
VAERS Form:1
Age:0.4
Gender:Female
Location:Foreign
Vaccinated:2008-04-10
Onset:2008-04-16
Submitted:2008-04-30
Entered:2008-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal distension, Intestinal obstruction, Intussusception, Surgery, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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': B0517644A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 5-month-old female subject who was vaccinated with Rotarix (GlaxoSmithKline). No concomitant medication was given to the subject. On 10 April 2008, the subject received unspecified dose of Rotarix (oral), lot number not provided. On 16 April 2008, 6 days after vaccination with Rotarix, the subject experienced abdominal distension and vomiting. On 18 April 2008, the subject was hospitalised. The exam performed showed intestinal obstruction. A surgery was performed and intussusception was found. The physician considered the events were life threatening and clinically significant (or requiring intervention). At the time of reporting the events were improved.


Changed on 8/14/2018

VAERS ID: 311333 Before After
VAERS Form:1
Age:0.4
Gender:Female
Location:Foreign
Vaccinated:2008-04-10
Onset:2008-04-16
Submitted:2008-04-30
Entered:2008-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal distension, Intestinal obstruction, Intussusception, Surgery, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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': B0517644A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 5-month-old female subject who was vaccinated with Rotarix (GlaxoSmithKline). No concomitant medication was given to the subject. On 10 April 2008, the subject received unspecified dose of Rotarix (oral), lot number not provided. On 16 April 2008, 6 days after vaccination with Rotarix, the subject experienced abdominal distension and vomiting. On 18 April 2008, the subject was hospitalised. The exam performed showed intestinal obstruction. A surgery was performed and intussusception was found. The physician considered the events were life threatening and clinically significant (or requiring intervention). At the time of reporting the events were improved.


Changed on 9/14/2018

VAERS ID: 311333 Before After
VAERS Form:1
Age:0.4
Gender:Female
Location:Foreign
Vaccinated:2008-04-10
Onset:2008-04-16
Submitted:2008-04-30
Entered:2008-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal distension, Intestinal obstruction, Intussusception, Surgery, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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': B0517644A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 5-month-old female subject who was vaccinated with Rotarix (GlaxoSmithKline). No concomitant medication was given to the subject. On 10 April 2008, the subject received unspecified dose of Rotarix (oral), lot number not provided. On 16 April 2008, 6 days after vaccination with Rotarix, the subject experienced abdominal distension and vomiting. On 18 April 2008, the subject was hospitalised. The exam performed showed intestinal obstruction. A surgery was performed and intussusception was found. The physician considered the events were life threatening and clinically significant (or requiring intervention). At the time of reporting the events were improved.

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