National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 314128

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 314128
VAERS Form:
Age:0.3
Gender:Female
Location:Foreign
Vaccinated:2008-03-26
Onset:2008-04-07
Submitted:2008-05-29
Entered:2008-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / IM
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / IM
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Appendicectomy, Haematochezia, Intussusception, Mass, Mucous stools, Surgery, Vomiting, X-ray abnormal, Gastrointestinal hypomotility, Abdominal X-ray, Obstruction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 09Apr2008, Abnormalunit
CDC 'Split Type': B0522174A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 4-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject was under no other medication and had no relevant medical history nor allergy. Previous and/or concurrent vaccination included ROTARIX (GlaxoSmithKline); oral given on 29 January 2008; DTaP/IPV/Hib; manufacturer unspecified; intramuscular; given on 26 March 2008; pneumococcal vaccine; manufacturer unspecified; intramuscular; given on 26 March 2008. On 26 March 2008, the subject received 2nd dose of ROTARIX (oral), lot number not provided. On 7 April 2008, 12 days after vaccination with ROTARIX, the subject experienced 4 times vomiting and stools with mucus and blood. On 9 April 2008, the subject was brought to the emergency room where examination showed abdominal obstruction with decreased bowel peristalsis, dance sign and rectal tact with a palpable mass. Abdominal X-ray showed air fluid levels and abnormal gas distribution without distal air. The subject was hospitalised for 4 days. On 10 April 2008, surgery was performed and cecocolic intussusceptoin was found and resolved by taxis without complication. Furthermore, appendectomy was performed. The subject was treated with paracetamol, AMIKACINE, MECLIZINE, surgery and metronidazole. On 12 April 2008, the events were resolved and the subject was discharged from hospital in good clinical condition. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 5/13/2013

VAERS ID: 314128 Before After
VAERS Form:
Age:0.3
Gender:Female
Location:Foreign
Vaccinated:2008-03-26
Onset:2008-04-07
Submitted:2008-05-29
Entered:2008-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / IM
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / IM
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 - / PO
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Appendicectomy, Haematochezia, Intussusception, Mass, Mucous stools, Surgery, Vomiting, X-ray abnormal, Gastrointestinal hypomotility, Abdominal X-ray, Obstruction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 09Apr2008, Abnormalunit
CDC 'Split Type': B0522174A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 4-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject was under no other medication and had no relevant medical history nor allergy. Previous and/or concurrent vaccination included ROTARIX (GlaxoSmithKline); oral given on 29 January 2008; DTaP/IPV/Hib; manufacturer unspecified; intramuscular; given on 26 March 2008; pneumococcal vaccine; manufacturer unspecified; intramuscular; given on 26 March 2008. On 26 March 2008, the subject received 2nd dose of ROTARIX (oral), lot number not provided. On 7 April 2008, 12 days after vaccination with ROTARIX, the subject experienced 4 times vomiting and stools with mucus and blood. On 9 April 2008, the subject was brought to the emergency room where examination showed abdominal obstruction with decreased bowel peristalsis, dance sign and rectal tact with a palpable mass. Abdominal X-ray showed air fluid levels and abnormal gas distribution without distal air. The subject was hospitalised for 4 days. On 10 April 2008, surgery was performed and cecocolic intussusceptoin was found and resolved by taxis without complication. Furthermore, appendectomy was performed. The subject was treated with paracetamol, AMIKACINE, MECLIZINE, surgery and metronidazole. On 12 April 2008, the events were resolved and the subject was discharged from hospital in good clinical condition. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 9/14/2017

VAERS ID: 314128 Before After
VAERS Form:(blank) 1
Age:0.3
Gender:Female
Location:Foreign
Vaccinated:2008-03-26
Onset:2008-04-07
Submitted:2008-05-29
Entered:2008-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK UN / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK UN / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK UN / IM
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK UN / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 2 - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Appendicectomy, Haematochezia, Intussusception, Mass, Mucous stools, Surgery, Vomiting, X-ray abnormal, Gastrointestinal hypomotility, Abdominal X-ray, Obstruction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 09Apr2008, Abnormalunit
CDC 'Split Type': B0522174A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 4-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject was under no other medication and had no relevant medical history nor allergy. Previous and/or concurrent vaccination included ROTARIX (GlaxoSmithKline); oral given on 29 January 2008; DTaP/IPV/Hib; manufacturer unspecified; intramuscular; given on 26 March 2008; pneumococcal vaccine; manufacturer unspecified; intramuscular; given on 26 March 2008. On 26 March 2008, the subject received 2nd dose of ROTARIX (oral), lot number not provided. On 7 April 2008, 12 days after vaccination with ROTARIX, the subject experienced 4 times vomiting and stools with mucus and blood. On 9 April 2008, the subject was brought to the emergency room where examination showed abdominal obstruction with decreased bowel peristalsis, dance sign and rectal tact with a palpable mass. Abdominal X-ray showed air fluid levels and abnormal gas distribution without distal air. The subject was hospitalised for 4 days. On 10 April 2008, surgery was performed and cecocolic intussusceptoin was found and resolved by taxis without complication. Furthermore, appendectomy was performed. The subject was treated with paracetamol, AMIKACINE, MECLIZINE, surgery and metronidazole. On 12 April 2008, the events were resolved and the subject was discharged from hospital in good clinical condition. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 2/14/2018

VAERS ID: 314128 Before After
VAERS Form:1
Age:0.3
Gender:Female
Location:Foreign
Vaccinated:2008-03-26
Onset:2008-04-07
Submitted:2008-05-29
Entered:2008-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 2 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Appendicectomy, Haematochezia, Intussusception, Mass, Mucous stools, Surgery, Vomiting, X-ray abnormal, Gastrointestinal hypomotility, Abdominal X-ray, Obstruction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 09Apr2008, Abnormalunit
CDC 'Split Type': B0522174A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 4-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject was under no other medication and had no relevant medical history nor allergy. Previous and/or concurrent vaccination included ROTARIX (GlaxoSmithKline); oral given on 29 January 2008; DTaP/IPV/Hib; manufacturer unspecified; intramuscular; given on 26 March 2008; pneumococcal vaccine; manufacturer unspecified; intramuscular; given on 26 March 2008. On 26 March 2008, the subject received 2nd dose of ROTARIX (oral), lot number not provided. On 7 April 2008, 12 days after vaccination with ROTARIX, the subject experienced 4 times vomiting and stools with mucus and blood. On 9 April 2008, the subject was brought to the emergency room where examination showed abdominal obstruction with decreased bowel peristalsis, dance sign and rectal tact with a palpable mass. Abdominal X-ray showed air fluid levels and abnormal gas distribution without distal air. The subject was hospitalised for 4 days. On 10 April 2008, surgery was performed and cecocolic intussusceptoin was found and resolved by taxis without complication. Furthermore, appendectomy was performed. The subject was treated with paracetamol, AMIKACINE, MECLIZINE, surgery and metronidazole. On 12 April 2008, the events were resolved and the subject was discharged from hospital in good clinical condition. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 6/14/2018

VAERS ID: 314128 Before After
VAERS Form:1
Age:0.3
Gender:Female
Location:Foreign
Vaccinated:2008-03-26
Onset:2008-04-07
Submitted:2008-05-29
Entered:2008-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 2 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Appendicectomy, Haematochezia, Intussusception, Mass, Mucous stools, Surgery, Vomiting, X-ray abnormal, Gastrointestinal hypomotility, Abdominal X-ray, Obstruction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 09Apr2008, Abnormalunit
CDC 'Split Type': B0522174A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 4-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject was under no other medication and had no relevant medical history nor allergy. Previous and/or concurrent vaccination included ROTARIX (GlaxoSmithKline); oral given on 29 January 2008; DTaP/IPV/Hib; manufacturer unspecified; intramuscular; given on 26 March 2008; pneumococcal vaccine; manufacturer unspecified; intramuscular; given on 26 March 2008. On 26 March 2008, the subject received 2nd dose of ROTARIX (oral), lot number not provided. On 7 April 2008, 12 days after vaccination with ROTARIX, the subject experienced 4 times vomiting and stools with mucus and blood. On 9 April 2008, the subject was brought to the emergency room where examination showed abdominal obstruction with decreased bowel peristalsis, dance sign and rectal tact with a palpable mass. Abdominal X-ray showed air fluid levels and abnormal gas distribution without distal air. The subject was hospitalised for 4 days. On 10 April 2008, surgery was performed and cecocolic intussusceptoin was found and resolved by taxis without complication. Furthermore, appendectomy was performed. The subject was treated with paracetamol, AMIKACINE, MECLIZINE, surgery and metronidazole. On 12 April 2008, the events were resolved and the subject was discharged from hospital in good clinical condition. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 8/14/2018

VAERS ID: 314128 Before After
VAERS Form:1
Age:0.3
Gender:Female
Location:Foreign
Vaccinated:2008-03-26
Onset:2008-04-07
Submitted:2008-05-29
Entered:2008-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 2 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Appendicectomy, Haematochezia, Intussusception, Mass, Mucous stools, Surgery, Vomiting, X-ray abnormal, Gastrointestinal hypomotility, Abdominal X-ray, Obstruction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 09Apr2008, Abnormalunit
CDC 'Split Type': B0522174A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 4-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject was under no other medication and had no relevant medical history nor allergy. Previous and/or concurrent vaccination included ROTARIX (GlaxoSmithKline); oral given on 29 January 2008; DTaP/IPV/Hib; manufacturer unspecified; intramuscular; given on 26 March 2008; pneumococcal vaccine; manufacturer unspecified; intramuscular; given on 26 March 2008. On 26 March 2008, the subject received 2nd dose of ROTARIX (oral), lot number not provided. On 7 April 2008, 12 days after vaccination with ROTARIX, the subject experienced 4 times vomiting and stools with mucus and blood. On 9 April 2008, the subject was brought to the emergency room where examination showed abdominal obstruction with decreased bowel peristalsis, dance sign and rectal tact with a palpable mass. Abdominal X-ray showed air fluid levels and abnormal gas distribution without distal air. The subject was hospitalised for 4 days. On 10 April 2008, surgery was performed and cecocolic intussusceptoin was found and resolved by taxis without complication. Furthermore, appendectomy was performed. The subject was treated with paracetamol, AMIKACINE, MECLIZINE, surgery and metronidazole. On 12 April 2008, the events were resolved and the subject was discharged from hospital in good clinical condition. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 9/14/2018

VAERS ID: 314128 Before After
VAERS Form:1
Age:0.3
Gender:Female
Location:Foreign
Vaccinated:2008-03-26
Onset:2008-04-07
Submitted:2008-05-29
Entered:2008-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 2 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Appendicectomy, Haematochezia, Intussusception, Mass, Mucous stools, Surgery, Vomiting, X-ray abnormal, Gastrointestinal hypomotility, Abdominal X-ray, Obstruction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 09Apr2008, Abnormalunit
CDC 'Split Type': B0522174A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 4-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject was under no other medication and had no relevant medical history nor allergy. Previous and/or concurrent vaccination included ROTARIX (GlaxoSmithKline); oral given on 29 January 2008; DTaP/IPV/Hib; manufacturer unspecified; intramuscular; given on 26 March 2008; pneumococcal vaccine; manufacturer unspecified; intramuscular; given on 26 March 2008. On 26 March 2008, the subject received 2nd dose of ROTARIX (oral), lot number not provided. On 7 April 2008, 12 days after vaccination with ROTARIX, the subject experienced 4 times vomiting and stools with mucus and blood. On 9 April 2008, the subject was brought to the emergency room where examination showed abdominal obstruction with decreased bowel peristalsis, dance sign and rectal tact with a palpable mass. Abdominal X-ray showed air fluid levels and abnormal gas distribution without distal air. The subject was hospitalised for 4 days. On 10 April 2008, surgery was performed and cecocolic intussusceptoin was found and resolved by taxis without complication. Furthermore, appendectomy was performed. The subject was treated with paracetamol, AMIKACINE, MECLIZINE, surgery and metronidazole. On 12 April 2008, the events were resolved and the subject was discharged from hospital in good clinical condition. The physician considered the events were possibly related to vaccination with ROTARIX.

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=314128&WAYBACKHISTORY=ON


Copyright © 2018 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166