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This is VAERS ID 314130

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 314130
VAERS Form:
Age:0.3
Gender:Female
Location:Foreign
Vaccinated:2008-01-15
Onset:2008-04-19
Submitted:2008-05-29
Entered:2008-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Anorexia, Barium enema abnormal, Diarrhoea, Flatulence, Haematochezia, Intussusception, Mass, Mucous stools, Nausea, Pallor, Vomiting, White blood cell count decreased, X-ray abnormal, Intestinal functional disorder, Decreased appetite, Abdominal X-ray, Gastrointestinal sounds abnormal

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: Abdominal X-ray, 20Apr2008, See text; Barium enema, 20Apr2008, See text; White blood cell count, 20Apr2008, 4200/mm3, 5000, 1500
CDC 'Split Type': B0521383A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 7-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject had no relevant medical history or allergy. Previous vaccinations included combined diphtheria, tetanus, whole cell pertussis, hepatitis B and Haemophilus type b vaccine (manufacturer unspecified; intramuscular; unknown) given on 19 March 2008; influenza virus vaccine (manufacturer unspecified; intramuscular; unknown) given on 19 March 2008; live attenuated oral poliomyelitis vaccine (manufacturer unspecified; oral) given on 19 March 2008 and live attenuated human rotavirus vaccine (GlaxoSmithKline; oral) given on 12 November 2007. On 15 January 2008, the subject received the 2nd dose of ROTARIX (oral, lot number not provided). On 19 April 2008, 95 days after vaccination with the 2nd dose of ROTARIX, the subject experienced abdominal pain and liquid stools. Thereafter she showed hyporexia, nausea, vomiting and current jelly stools. On 20 April 2008, she was admitted on ER. Physical exam reported abdominal pain, pallor, palpable mass, Dance sign, absent peristalsis and rectal tract with expulsion of fresh bloody stools. Laboratory tests were performed on 20 April 2008 and showed the following: Leucocytes: 4200/mm3 (normal range: 5000-15000). Abdominal X-ray showed air-fluid levels. Barium enema was done; fluoroscopy control showed pass contrast medium through ileocecal valve to distal ileum; therefore ileocecolic intussusception was resolved (by exit). The subject was treated with AMPICILLIN, AMIKACINE, metronidazole and RANITIDINE. The subject had a good clinical evolution. The subject was discharged on 24 April 2008 with frank recuperation. On 24 April 2008, the events were resolved. The physician considered the events were unrelated to vaccination with ROTARIX.


Changed on 5/13/2013

VAERS ID: 314130 Before After
VAERS Form:
Age:0.3
Gender:Female
Location:Foreign
Vaccinated:2008-01-15
Onset:2008-04-19
Submitted:2008-05-29
Entered:2008-05-29
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 pain, Anorexia, Barium enema abnormal, Diarrhoea, Flatulence, Haematochezia, Intussusception, Mass, Mucous stools, Nausea, Pallor, Vomiting, White blood cell count decreased, X-ray abnormal, Intestinal functional disorder, Decreased appetite, Abdominal X-ray, Gastrointestinal sounds abnormal

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: Abdominal X-ray, 20Apr2008, See text; Barium enema, 20Apr2008, See text; White blood cell count, 20Apr2008, 4200/mm3, 5000, 1500
CDC 'Split Type': B0521383A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 7-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject had no relevant medical history or allergy. Previous vaccinations included combined diphtheria, tetanus, whole cell pertussis, hepatitis B and Haemophilus type b vaccine (manufacturer unspecified; intramuscular; unknown) given on 19 March 2008; influenza virus vaccine (manufacturer unspecified; intramuscular; unknown) given on 19 March 2008; live attenuated oral poliomyelitis vaccine (manufacturer unspecified; oral) given on 19 March 2008 and live attenuated human rotavirus vaccine (GlaxoSmithKline; oral) given on 12 November 2007. On 15 January 2008, the subject received the 2nd dose of ROTARIX (oral, lot number not provided). On 19 April 2008, 95 days after vaccination with the 2nd dose of ROTARIX, the subject experienced abdominal pain and liquid stools. Thereafter she showed hyporexia, nausea, vomiting and current jelly stools. On 20 April 2008, she was admitted on ER. Physical exam reported abdominal pain, pallor, palpable mass, Dance sign, absent peristalsis and rectal tract with expulsion of fresh bloody stools. Laboratory tests were performed on 20 April 2008 and showed the following: Leucocytes: 4200/mm3 (normal range: 5000-15000). Abdominal X-ray showed air-fluid levels. Barium enema was done; fluoroscopy control showed pass contrast medium through ileocecal valve to distal ileum; therefore ileocecolic intussusception was resolved (by exit). The subject was treated with AMPICILLIN, AMIKACINE, metronidazole and RANITIDINE. The subject had a good clinical evolution. The subject was discharged on 24 April 2008 with frank recuperation. On 24 April 2008, the events were resolved. The physician considered the events were unrelated to vaccination with ROTARIX.


Changed on 9/14/2017

VAERS ID: 314130 Before After
VAERS Form:(blank) 1
Age:0.3
Gender:Female
Location:Foreign
Vaccinated:2008-01-15
Onset:2008-04-19
Submitted:2008-05-29
Entered:2008-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 2 - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Anorexia, Barium enema abnormal, Diarrhoea, Flatulence, Haematochezia, Intussusception, Mass, Mucous stools, Nausea, Pallor, Vomiting, White blood cell count decreased, X-ray abnormal, Intestinal functional disorder, Decreased appetite, Abdominal X-ray, Gastrointestinal sounds abnormal

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: Abdominal X-ray, 20Apr2008, See text; Barium enema, 20Apr2008, See text; White blood cell count, 20Apr2008, 4200/mm3, 5000, 1500
CDC 'Split Type': B0521383A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 7-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject had no relevant medical history or allergy. Previous vaccinations included combined diphtheria, tetanus, whole cell pertussis, hepatitis B and Haemophilus type b vaccine (manufacturer unspecified; intramuscular; unknown) given on 19 March 2008; influenza virus vaccine (manufacturer unspecified; intramuscular; unknown) given on 19 March 2008; live attenuated oral poliomyelitis vaccine (manufacturer unspecified; oral) given on 19 March 2008 and live attenuated human rotavirus vaccine (GlaxoSmithKline; oral) given on 12 November 2007. On 15 January 2008, the subject received the 2nd dose of ROTARIX (oral, lot number not provided). On 19 April 2008, 95 days after vaccination with the 2nd dose of ROTARIX, the subject experienced abdominal pain and liquid stools. Thereafter she showed hyporexia, nausea, vomiting and current jelly stools. On 20 April 2008, she was admitted on ER. Physical exam reported abdominal pain, pallor, palpable mass, Dance sign, absent peristalsis and rectal tract with expulsion of fresh bloody stools. Laboratory tests were performed on 20 April 2008 and showed the following: Leucocytes: 4200/mm3 (normal range: 5000-15000). Abdominal X-ray showed air-fluid levels. Barium enema was done; fluoroscopy control showed pass contrast medium through ileocecal valve to distal ileum; therefore ileocecolic intussusception was resolved (by exit). The subject was treated with AMPICILLIN, AMIKACINE, metronidazole and RANITIDINE. The subject had a good clinical evolution. The subject was discharged on 24 April 2008 with frank recuperation. On 24 April 2008, the events were resolved. The physician considered the events were unrelated to vaccination with ROTARIX.


Changed on 2/14/2018

VAERS ID: 314130 Before After
VAERS Form:1
Age:0.3
Gender:Female
Location:Foreign
Vaccinated:2008-01-15
Onset:2008-04-19
Submitted:2008-05-29
Entered:2008-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 2 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Anorexia, Barium enema abnormal, Diarrhoea, Flatulence, Haematochezia, Intussusception, Mass, Mucous stools, Nausea, Pallor, Vomiting, White blood cell count decreased, X-ray abnormal, Intestinal functional disorder, Decreased appetite, Abdominal X-ray, Gastrointestinal sounds abnormal

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: Abdominal X-ray, 20Apr2008, See text; Barium enema, 20Apr2008, See text; White blood cell count, 20Apr2008, 4200/mm3, 5000, 1500
CDC 'Split Type': B0521383A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 7-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject had no relevant medical history or allergy. Previous vaccinations included combined diphtheria, tetanus, whole cell pertussis, hepatitis B and Haemophilus type b vaccine (manufacturer unspecified; intramuscular; unknown) given on 19 March 2008; influenza virus vaccine (manufacturer unspecified; intramuscular; unknown) given on 19 March 2008; live attenuated oral poliomyelitis vaccine (manufacturer unspecified; oral) given on 19 March 2008 and live attenuated human rotavirus vaccine (GlaxoSmithKline; oral) given on 12 November 2007. On 15 January 2008, the subject received the 2nd dose of ROTARIX (oral, lot number not provided). On 19 April 2008, 95 days after vaccination with the 2nd dose of ROTARIX, the subject experienced abdominal pain and liquid stools. Thereafter she showed hyporexia, nausea, vomiting and current jelly stools. On 20 April 2008, she was admitted on ER. Physical exam reported abdominal pain, pallor, palpable mass, Dance sign, absent peristalsis and rectal tract with expulsion of fresh bloody stools. Laboratory tests were performed on 20 April 2008 and showed the following: Leucocytes: 4200/mm3 (normal range: 5000-15000). Abdominal X-ray showed air-fluid levels. Barium enema was done; fluoroscopy control showed pass contrast medium through ileocecal valve to distal ileum; therefore ileocecolic intussusception was resolved (by exit). The subject was treated with AMPICILLIN, AMIKACINE, metronidazole and RANITIDINE. The subject had a good clinical evolution. The subject was discharged on 24 April 2008 with frank recuperation. On 24 April 2008, the events were resolved. The physician considered the events were unrelated to vaccination with ROTARIX.

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