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This is VAERS ID 317252

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 317252
VAERS Form:
Age:0.2
Gender:Female
Location:Foreign
Vaccinated:2008-04-08
Onset:2008-05-27
Submitted:2008-06-24
Entered:2008-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 0 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Activated partial thromboplastin time shortened, Appendicectomy, Culture urine positive, Dehydration, Gastrointestinal necrosis, Haematochezia, Haematocrit normal, Haemoglobin normal, Intussusception, Malaise, Monocyte count increased, Monocyte count normal, Neutrophil count increased, Pallor, Platelet count normal, Prothrombin time normal, Pyrexia, Vomiting, White blood cell count increased, Gastrointestinal hypermotility, Ileectomy, Ischaemia

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: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Hematocrit, 29May2008, 33.5%, 29-42; Hemoglobin, 29May2008, 11.7g/dl, 10-13; Monocytes, 29May2008, 9%, 5-7; Neutrophils, 29May2008, 57%, 13-33; Platelet count, 29May2008, 59000mm3, 300000-700000; White blood cells, 29May2008, 18200mm3, 1000
CDC 'Split Type': B0525017A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of ileocolic intussusception in a 3-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject was previously healthy. The subject was on no other medication and had no relevant medical history. On 8 April 2008, the subject received 1st dose of ROTARIX (oral). On 27 May 2008, 49 days after vaccination with ROTARIX, the subject experienced ileocolic intussusception, fever, vomiting, current jelly stool, malaise, pallor, dehydration, abdominal pain and hyperperistalsis. The subject was hospitalised for 9 days. X ray abdomen not available in the clinical file. Surgery was performed on 29 May 2008, ileocolic invagination with schemia and necrosis to 10 cm of ileocecal valve was found (distal ileon). Resection of necrotic ileon segment (15 cm) at 5 cm of ileocecal valve and appendectomy was done without complications. Post surgical evolution was slowly to improvement. The subject was treated with ampicillin and paracetamol. On 6 June 2008, the events were resolved and the subject was discharged in good clinical conditions. The physician considered the events were unrelated to vaccination with ROTARIX.


Changed on 5/13/2013

VAERS ID: 317252 Before After
VAERS Form:
Age:0.2
Gender:Female
Location:Foreign
Vaccinated:2008-04-08
Onset:2008-05-27
Submitted:2008-06-24
Entered:2008-06-24
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: Abdominal pain, Activated partial thromboplastin time shortened, Appendicectomy, Culture urine positive, Dehydration, Gastrointestinal necrosis, Haematochezia, Haematocrit normal, Haemoglobin normal, Intussusception, Malaise, Monocyte count increased, Monocyte count normal, Neutrophil count increased, Pallor, Platelet count normal, Prothrombin time normal, Pyrexia, Vomiting, White blood cell count increased, Gastrointestinal hypermotility, Ileectomy, Ischaemia

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: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Hematocrit, 29May2008, 33.5%, 29-42; Hemoglobin, 29May2008, 11.7g/dl, 10-13; Monocytes, 29May2008, 9%, 5-7; Neutrophils, 29May2008, 57%, 13-33; Platelet count, 29May2008, 59000mm3, 300000-700000; White blood cells, 29May2008, 18200mm3, 1000
CDC 'Split Type': B0525017A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of ileocolic intussusception in a 3-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject was previously healthy. The subject was on no other medication and had no relevant medical history. On 8 April 2008, the subject received 1st dose of ROTARIX (oral). On 27 May 2008, 49 days after vaccination with ROTARIX, the subject experienced ileocolic intussusception, fever, vomiting, current jelly stool, malaise, pallor, dehydration, abdominal pain and hyperperistalsis. The subject was hospitalised for 9 days. X ray abdomen not available in the clinical file. Surgery was performed on 29 May 2008, ileocolic invagination with schemia and necrosis to 10 cm of ileocecal valve was found (distal ileon). Resection of necrotic ileon segment (15 cm) at 5 cm of ileocecal valve and appendectomy was done without complications. Post surgical evolution was slowly to improvement. The subject was treated with ampicillin and paracetamol. On 6 June 2008, the events were resolved and the subject was discharged in good clinical conditions. The physician considered the events were unrelated to vaccination with ROTARIX.


Changed on 4/14/2017

VAERS ID: 317252 Before After
VAERS Form:
Age:0.2
Gender:Female
Location:Foreign
Vaccinated:2008-04-08
Onset:2008-05-27
Submitted:2008-06-24
Entered:2008-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 0 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Activated partial thromboplastin time shortened, Appendicectomy, Culture urine positive, Dehydration, Gastrointestinal necrosis, Haematochezia, Haematocrit normal, Haemoglobin normal, Intussusception, Malaise, Monocyte count increased, Monocyte count normal, Neutrophil count increased, Pallor, Platelet count normal, Prothrombin time normal, Pyrexia, Vomiting, White blood cell count increased, Gastrointestinal hypermotility, Ileectomy, Ischaemia

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: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Hematocrit, 29May2008, 33.5%, 29-42; Hemoglobin, 29May2008, 11.7g/dl, 10-13; Monocytes, 29May2008, 9%, 5-7; Neutrophils, 29May2008, 57%, 13-33; Platelet count, 29May2008, 59000mm3, 300000-700000; White blood cells, 29May2008, 18200mm3, 1000 10000-15000. 29 May2008: PT =12 reg. (low norm=10.1, high norm=15.9); PTT: 27.5 reg. (low norm=31.3, high norm 54); Urinary exam showed bacterium positive, Leucocytes 10-12
CDC 'Split Type': B0525017A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of ileocolic intussusception in a 3-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject was previously healthy. The subject was on no other medication and had no relevant medical history. On 8 April 2008, the subject received 1st dose of ROTARIX (oral). On 27 May 2008, 49 days after vaccination with ROTARIX, the subject experienced ileocolic intussusception, fever, vomiting, current jelly stool, malaise, pallor, dehydration, abdominal pain and hyperperistalsis. The subject was hospitalised for 9 days. X ray abdomen not available in the clinical file. Surgery was performed on 29 May 2008, ileocolic invagination with schemia and necrosis to 10 cm of ileocecal valve was found (distal ileon). Resection of necrotic ileon segment (15 cm) at 5 cm of ileocecal valve and appendectomy was done without complications. Post surgical evolution was slowly to improvement. The subject was treated with ampicillin and paracetamol. On 6 June 2008, the events were resolved and the subject was discharged in good clinical conditions. The physician considered the events were unrelated to vaccination with ROTARIX.


Changed on 9/14/2017

VAERS ID: 317252 Before After
VAERS Form:(blank) 1
Age:0.2
Gender:Female
Location:Foreign
Vaccinated:2008-04-08
Onset:2008-05-27
Submitted:2008-06-24
Entered:2008-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 0 1 - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Activated partial thromboplastin time shortened, Appendicectomy, Culture urine positive, Dehydration, Gastrointestinal necrosis, Haematochezia, Haematocrit normal, Haemoglobin normal, Intussusception, Malaise, Monocyte count increased, Monocyte count normal, Neutrophil count increased, Pallor, Platelet count normal, Prothrombin time normal, Pyrexia, Vomiting, White blood cell count increased, Gastrointestinal hypermotility, Ileectomy, Ischaemia

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: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Hematocrit, 29May2008, 33.5%, 29-42; Hemoglobin, 29May2008, 11.7g/dl, 10-13; Monocytes, 29May2008, 9%, 5-7; Neutrophils, 29May2008, 57%, 13-33; Platelet count, 29May2008, 59000mm3, 300000-700000; White blood cells, 29May2008, 18200mm3, 10000-15000. 29 May2008: PT =12 reg. (low norm=10.1, high norm=15.9); PTT: 27.5 reg. (low norm=31.3, high norm 54); Urinary exam showed bacterium positive, Leucocytes 10-12
CDC 'Split Type': B0525017A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of ileocolic intussusception in a 3-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject was previously healthy. The subject was on no other medication and had no relevant medical history. On 8 April 2008, the subject received 1st dose of ROTARIX (oral). On 27 May 2008, 49 days after vaccination with ROTARIX, the subject experienced ileocolic intussusception, fever, vomiting, current jelly stool, malaise, pallor, dehydration, abdominal pain and hyperperistalsis. The subject was hospitalised for 9 days. X ray abdomen not available in the clinical file. Surgery was performed on 29 May 2008, ileocolic invagination with schemia and necrosis to 10 cm of ileocecal valve was found (distal ileon). Resection of necrotic ileon segment (15 cm) at 5 cm of ileocecal valve and appendectomy was done without complications. Post surgical evolution was slowly to improvement. The subject was treated with ampicillin and paracetamol. On 6 June 2008, the events were resolved and the subject was discharged in good clinical conditions. The physician considered the events were unrelated to vaccination with ROTARIX.


Changed on 2/14/2018

VAERS ID: 317252 Before After
VAERS Form:1
Age:0.2
Gender:Female
Location:Foreign
Vaccinated:2008-04-08
Onset:2008-05-27
Submitted:2008-06-24
Entered:2008-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Activated partial thromboplastin time shortened, Appendicectomy, Culture urine positive, Dehydration, Gastrointestinal necrosis, Haematochezia, Haematocrit normal, Haemoglobin normal, Intussusception, Malaise, Monocyte count increased, Monocyte count normal, Neutrophil count increased, Pallor, Platelet count normal, Prothrombin time normal, Pyrexia, Vomiting, White blood cell count increased, Gastrointestinal hypermotility, Ileectomy, Ischaemia

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: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Hematocrit, 29May2008, 33.5%, 29-42; Hemoglobin, 29May2008, 11.7g/dl, 10-13; Monocytes, 29May2008, 9%, 5-7; Neutrophils, 29May2008, 57%, 13-33; Platelet count, 29May2008, 59000mm3, 300000-700000; White blood cells, 29May2008, 18200mm3, 10000-15000. 29 May2008: PT =12 reg. (low norm=10.1, high norm=15.9); PTT: 27.5 reg. (low norm=31.3, high norm 54); Urinary exam showed bacterium positive, Leucocytes 10-12
CDC 'Split Type': B0525017A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of ileocolic intussusception in a 3-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject was previously healthy. The subject was on no other medication and had no relevant medical history. On 8 April 2008, the subject received 1st dose of ROTARIX (oral). On 27 May 2008, 49 days after vaccination with ROTARIX, the subject experienced ileocolic intussusception, fever, vomiting, current jelly stool, malaise, pallor, dehydration, abdominal pain and hyperperistalsis. The subject was hospitalised for 9 days. X ray abdomen not available in the clinical file. Surgery was performed on 29 May 2008, ileocolic invagination with schemia and necrosis to 10 cm of ileocecal valve was found (distal ileon). Resection of necrotic ileon segment (15 cm) at 5 cm of ileocecal valve and appendectomy was done without complications. Post surgical evolution was slowly to improvement. The subject was treated with ampicillin and paracetamol. On 6 June 2008, the events were resolved and the subject was discharged in good clinical conditions. The physician considered the events were unrelated to vaccination with ROTARIX.


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