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This is VAERS ID 315141

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

315141
VAERS Form:
Age:0.2
Gender:Female
Location:Foreign
Vaccinated:2008-05-07
Onset:2008-05-26
Submitted:2008-06-05
Entered:2008-06-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Intussusception, Rectal haemorrhage, Surgery, X-ray abnormal, Abdominal X-ray

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: Abdominal X-ray, 26May2008, Abnormalunit
CDC 'Split Type': B0522850A

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). On 7 May 2008, the subject received 1st dose of ROTARIX (oral), lot number not provided. On 26 May 2008, 19 days after vaccination with ROTARIX, the subject experienced rectal bleeding and abdominal pain. The diagnosis of intussusception was made based on symptoms evaluation and abdomen X-ray. The subject was hospitalised and the physician considered the events were life threatening and clinically significant (or requiring intervention).Surgery was performed on 26 May 2008. At the time of reporting the events were improved. The subject was still hospitalised and oral feeding was began.


Changed on 5/13/2013

315141 Before After
VAERS Form:
Age:0.2
Gender:Female
Location:Foreign
Vaccinated:2008-05-07
Onset:2008-05-26
Submitted:2008-06-05
Entered:2008-06-05
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 pain, Intussusception, Rectal haemorrhage, Surgery, X-ray abnormal, Abdominal X-ray

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: Abdominal X-ray, 26May2008, Abnormalunit
CDC 'Split Type': B0522850A

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). On 7 May 2008, the subject received 1st dose of ROTARIX (oral), lot number not provided. On 26 May 2008, 19 days after vaccination with ROTARIX, the subject experienced rectal bleeding and abdominal pain. The diagnosis of intussusception was made based on symptoms evaluation and abdomen X-ray. The subject was hospitalised and the physician considered the events were life threatening and clinically significant (or requiring intervention).Surgery was performed on 26 May 2008. At the time of reporting the events were improved. The subject was still hospitalised and oral feeding was began.


Changed on 9/14/2017

315141 Before After
VAERS Form:(blank) 1
Age:0.2
Gender:Female
Location:Foreign
Vaccinated:2008-05-07
Onset:2008-05-26
Submitted:2008-06-05
Entered:2008-06-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - UNK - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Intussusception, Rectal haemorrhage, Surgery, X-ray abnormal, Abdominal X-ray

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: Abdominal X-ray, 26May2008, Abnormalunit
CDC 'Split Type': B0522850A

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). On 7 May 2008, the subject received 1st dose of ROTARIX (oral), lot number not provided. On 26 May 2008, 19 days after vaccination with ROTARIX, the subject experienced rectal bleeding and abdominal pain. The diagnosis of intussusception was made based on symptoms evaluation and abdomen X-ray. The subject was hospitalised and the physician considered the events were life threatening and clinically significant (or requiring intervention).Surgery was performed on 26 May 2008. At the time of reporting the events were improved. The subject was still hospitalised and oral feeding was began.


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