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This is VAERS ID 314409

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 314409
VAERS Form:
Age:0.3
Gender:Female
Location:Foreign
Vaccinated:2008-04-30
Onset:2008-05-05
Submitted:2008-05-30
Entered:2008-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 0 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Malaise, Enema administration, Ultrasound abdomen 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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ultrasound abdomen, 06May2008, ISunit
CDC 'Split Type': B0522202A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 3-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject was in her weight and size according to her age and in good health. The subject''s did not have any medical history of intussusception. She had a twin sister who received ROTARIX the same day without developing any adverse event. On 30 April 2008 the subject received 1st dose of ROTARIX (oral) lot number not provided. On 5 May 2008, 5 days after vaccination with ROTARIX, the subject started to feeling unwell. On 06 May 2008 the subject was brought to hospital and intussusception was diagnosed after abdominal ultrasound. The subject did not have fever or diarrhea or bloody stools. The subject was hospitalised for 5 days and discharged completely recovered. The subject was treated with enema. The physician considered the events were almost certainly related to vaccination with ROTARIX. Further information was not expected and therefore this case has been closed.


Changed on 5/13/2013

VAERS ID: 314409 Before After
VAERS Form:
Age:0.3
Gender:Female
Location:Foreign
Vaccinated:2008-04-30
Onset:2008-05-05
Submitted:2008-05-30
Entered:2008-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 0 - / PO
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 0 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Malaise, Enema administration, Ultrasound abdomen 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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ultrasound abdomen, 06May2008, ISunit
CDC 'Split Type': B0522202A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 3-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject was in her weight and size according to her age and in good health. The subject''s did not have any medical history of intussusception. She had a twin sister who received ROTARIX the same day without developing any adverse event. On 30 April 2008 the subject received 1st dose of ROTARIX (oral) lot number not provided. On 5 May 2008, 5 days after vaccination with ROTARIX, the subject started to feeling unwell. On 06 May 2008 the subject was brought to hospital and intussusception was diagnosed after abdominal ultrasound. The subject did not have fever or diarrhea or bloody stools. The subject was hospitalised for 5 days and discharged completely recovered. The subject was treated with enema. The physician considered the events were almost certainly related to vaccination with ROTARIX. Further information was not expected and therefore this case has been closed.


Changed on 9/14/2017

VAERS ID: 314409 Before After
VAERS Form:(blank) 1
Age:0.3
Gender:Female
Location:Foreign
Vaccinated:2008-04-30
Onset:2008-05-05
Submitted:2008-05-30
Entered:2008-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 0 1 - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Malaise, Enema administration, Ultrasound abdomen 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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ultrasound abdomen, 06May2008, ISunit
CDC 'Split Type': B0522202A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 3-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject was in her weight and size according to her age and in good health. The subject''s did not have any medical history of intussusception. She had a twin sister who received ROTARIX the same day without developing any adverse event. On 30 April 2008 the subject received 1st dose of ROTARIX (oral) lot number not provided. On 5 May 2008, 5 days after vaccination with ROTARIX, the subject started to feeling unwell. On 06 May 2008 the subject was brought to hospital and intussusception was diagnosed after abdominal ultrasound. The subject did not have fever or diarrhea or bloody stools. The subject was hospitalised for 5 days and discharged completely recovered. The subject was treated with enema. The physician considered the events were almost certainly related to vaccination with ROTARIX. Further information was not expected and therefore this case has been closed.


Changed on 2/14/2018

VAERS ID: 314409 Before After
VAERS Form:1
Age:0.3
Gender:Female
Location:Foreign
Vaccinated:2008-04-30
Onset:2008-05-05
Submitted:2008-05-30
Entered:2008-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Malaise, Enema administration, Ultrasound abdomen 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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ultrasound abdomen, 06May2008, ISunit
CDC 'Split Type': B0522202A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 3-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject was in her weight and size according to her age and in good health. The subject''s did not have any medical history of intussusception. She had a twin sister who received ROTARIX the same day without developing any adverse event. On 30 April 2008 the subject received 1st dose of ROTARIX (oral) lot number not provided. On 5 May 2008, 5 days after vaccination with ROTARIX, the subject started to feeling unwell. On 06 May 2008 the subject was brought to hospital and intussusception was diagnosed after abdominal ultrasound. The subject did not have fever or diarrhea or bloody stools. The subject was hospitalised for 5 days and discharged completely recovered. The subject was treated with enema. The physician considered the events were almost certainly related to vaccination with ROTARIX. Further information was not expected and therefore this case has been closed.


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