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This is VAERS ID 312272

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

312272
VAERS Form:
Age:0.3
Gender:Unknown
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2008-05-13
Entered:2008-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - - / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0504877A

Write-up:This case was reported by a physician and described the occurrence of intussusception in a 3.5-month-old subject of unspecified gender who was vaccinated with ROTARIX (GlaxoSmithKline) for prophylaxis. On an unspecified date the subject received the 1st dose of ROTARIX (oral). Eight days after vaccination with the 1st dose of ROTARIX, the subject experienced intussusception. The physician considered the event was clinically significant (or requiring intervention). At the time of reporting the outcome of the event was unspecified. Follow up information received on 01 May 2008: the subject''s age is 3.5 months instead of years as initially reported. Further information has been requested (Targeted Follow-Up Questionnaire for intussusception), but it was impossible to obtain additional details from the reporter as she did not recall any more data of the event so as to complete the form; this case has been therefore considered closed.


Changed on 5/13/2013

312272 Before After
VAERS Form:
Age:0.3
Gender:Unknown
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2008-05-13
Entered:2008-05-13
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: Intussusception

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0504877A

Write-up:This case was reported by a physician and described the occurrence of intussusception in a 3.5-month-old subject of unspecified gender who was vaccinated with ROTARIX (GlaxoSmithKline) for prophylaxis. On an unspecified date the subject received the 1st dose of ROTARIX (oral). Eight days after vaccination with the 1st dose of ROTARIX, the subject experienced intussusception. The physician considered the event was clinically significant (or requiring intervention). At the time of reporting the outcome of the event was unspecified. Follow up information received on 01 May 2008: the subject''s age is 3.5 months instead of years as initially reported. Further information has been requested (Targeted Follow-Up Questionnaire for intussusception), but it was impossible to obtain additional details from the reporter as she did not recall any more data of the event so as to complete the form; this case has been therefore considered closed.


Changed on 2/14/2017

312272 Before After
VAERS Form:
Age:0.3 0.25
Gender:Unknown
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2008-05-13
Entered:2008-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - - / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0504877A

Write-up:This case was reported by a physician and described the occurrence of intussusception in a 3.5-month-old subject of unspecified gender who was vaccinated with ROTARIX (GlaxoSmithKline) for prophylaxis. On an unspecified date the subject received the 1st dose of ROTARIX (oral). Eight days after vaccination with the 1st dose of ROTARIX, the subject experienced intussusception. The physician considered the event was clinically significant (or requiring intervention). At the time of reporting the outcome of the event was unspecified. Follow up information received on 01 May 2008: the subject''s age is 3.5 months instead of years as initially reported. Further information has been requested (Targeted Follow-Up Questionnaire for intussusception), but it was impossible to obtain additional details from the reporter as she did not recall any more data of the event so as to complete the form; this case has been therefore considered closed.


Changed on 9/14/2017

312272 Before After
VAERS Form:(blank) 1
Age:0.25
Gender:Unknown
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2008-05-13
Entered:2008-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - UNK - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0504877A

Write-up:This case was reported by a physician and described the occurrence of intussusception in a 3.5-month-old subject of unspecified gender who was vaccinated with ROTARIX (GlaxoSmithKline) for prophylaxis. On an unspecified date the subject received the 1st dose of ROTARIX (oral). Eight days after vaccination with the 1st dose of ROTARIX, the subject experienced intussusception. The physician considered the event was clinically significant (or requiring intervention). At the time of reporting the outcome of the event was unspecified. Follow up information received on 01 May 2008: the subject''s age is 3.5 months instead of years as initially reported. Further information has been requested (Targeted Follow-Up Questionnaire for intussusception), but it was impossible to obtain additional details from the reporter as she did not recall any more data of the event so as to complete the form; this case has been therefore considered closed.


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