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This is VAERS ID 317778

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 317778
VAERS Form:
Age:0.4
Gender:Male
Location:Foreign
Vaccinated:2008-04-14
Onset:2008-06-02
Submitted:2008-06-27
Entered:2008-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal distension, Abdominal tenderness, Acidosis, Appendicectomy, Convulsion, Dehydration, Diarrhoea, Haematochezia, Hypovolaemic shock, Intussusception, Mucous stools, Pain, Pyrexia, Surgery, Vomiting, Abdominal X-ray, Gastrointestinal sounds abnormal

Life Threatening? Yes
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: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 05Jun2008, see textunit
CDC 'Split Type': B0526485A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 5-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). Previous vaccination included ROTARIX (GlaxoSmithKline); oral given on 5 February 2008. On 14 April 2008 the subject received 2nd dose of ROTARIX (oral). On 2 June 2008, 49 days after vaccination with ROTARIX, the subject experienced high fever (not quantified), loose stools with mucous and blood, and vomiting (unknown number of episodes). Therefore he was treated as outpatient without improvement. On 05 June 2008 the subject presented 3 episodes of generalise seizure, therefore he was hospitalised. Physical examination included bad general conditions, severe dehydration, clinical data of hypovolemic shock with acidosis, abdominal distention, painful at median and deep pressure, peritoneal reaction and abolished peristalsis. Abdominal x-ray showed distended loops and intestinal obstruction. The subject was rehydrated with plan "C" from an organization. The same day the subject underwent a surgery in which intussusception was confirmed. An appendectomy was also done. After surgery the subject evolved to clinical improvement. On 10 June 2008 the subject was discharged in good clinical conditions. Seizure was considered as secondary to fever. No specific studies were done. The subject was hospitalised for 6 days and the physician considered the events were life threatening. The subject was treated with metoclopramide, metronadizole, paracetamol, ampicillin, metamizole, diazepam, amikacin, midazolam, rehydration and surgery.


Changed on 5/13/2013

VAERS ID: 317778 Before After
VAERS Form:
Age:0.4
Gender:Male
Location:Foreign
Vaccinated:2008-04-14
Onset:2008-06-02
Submitted:2008-06-27
Entered:2008-06-27
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 distension, Abdominal tenderness, Acidosis, Appendicectomy, Convulsion, Dehydration, Diarrhoea, Haematochezia, Hypovolaemic shock, Intussusception, Mucous stools, Pain, Pyrexia, Surgery, Vomiting, Abdominal X-ray, Gastrointestinal sounds abnormal

Life Threatening? Yes
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: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 05Jun2008, see textunit
CDC 'Split Type': B0526485A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 5-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). Previous vaccination included ROTARIX (GlaxoSmithKline); oral given on 5 February 2008. On 14 April 2008 the subject received 2nd dose of ROTARIX (oral). On 2 June 2008, 49 days after vaccination with ROTARIX, the subject experienced high fever (not quantified), loose stools with mucous and blood, and vomiting (unknown number of episodes). Therefore he was treated as outpatient without improvement. On 05 June 2008 the subject presented 3 episodes of generalise seizure, therefore he was hospitalised. Physical examination included bad general conditions, severe dehydration, clinical data of hypovolemic shock with acidosis, abdominal distention, painful at median and deep pressure, peritoneal reaction and abolished peristalsis. Abdominal x-ray showed distended loops and intestinal obstruction. The subject was rehydrated with plan "C" from an organization. The same day the subject underwent a surgery in which intussusception was confirmed. An appendectomy was also done. After surgery the subject evolved to clinical improvement. On 10 June 2008 the subject was discharged in good clinical conditions. Seizure was considered as secondary to fever. No specific studies were done. The subject was hospitalised for 6 days and the physician considered the events were life threatening. The subject was treated with metoclopramide, metronadizole, paracetamol, ampicillin, metamizole, diazepam, amikacin, midazolam, rehydration and surgery.


Changed on 9/14/2017

VAERS ID: 317778 Before After
VAERS Form:(blank) 1
Age:0.4
Gender:Male
Location:Foreign
Vaccinated:2008-04-14
Onset:2008-06-02
Submitted:2008-06-27
Entered:2008-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 2 - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal distension, Abdominal tenderness, Acidosis, Appendicectomy, Convulsion, Dehydration, Diarrhoea, Haematochezia, Hypovolaemic shock, Intussusception, Mucous stools, Pain, Pyrexia, Surgery, Vomiting, Abdominal X-ray, Gastrointestinal sounds abnormal

Life Threatening? Yes
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: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 05Jun2008, see textunit
CDC 'Split Type': B0526485A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 5-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). Previous vaccination included ROTARIX (GlaxoSmithKline); oral given on 5 February 2008. On 14 April 2008 the subject received 2nd dose of ROTARIX (oral). On 2 June 2008, 49 days after vaccination with ROTARIX, the subject experienced high fever (not quantified), loose stools with mucous and blood, and vomiting (unknown number of episodes). Therefore he was treated as outpatient without improvement. On 05 June 2008 the subject presented 3 episodes of generalise seizure, therefore he was hospitalised. Physical examination included bad general conditions, severe dehydration, clinical data of hypovolemic shock with acidosis, abdominal distention, painful at median and deep pressure, peritoneal reaction and abolished peristalsis. Abdominal x-ray showed distended loops and intestinal obstruction. The subject was rehydrated with plan "C" from an organization. The same day the subject underwent a surgery in which intussusception was confirmed. An appendectomy was also done. After surgery the subject evolved to clinical improvement. On 10 June 2008 the subject was discharged in good clinical conditions. Seizure was considered as secondary to fever. No specific studies were done. The subject was hospitalised for 6 days and the physician considered the events were life threatening. The subject was treated with metoclopramide, metronadizole, paracetamol, ampicillin, metamizole, diazepam, amikacin, midazolam, rehydration and surgery.


Changed on 2/14/2018

VAERS ID: 317778 Before After
VAERS Form:1
Age:0.4
Gender:Male
Location:Foreign
Vaccinated:2008-04-14
Onset:2008-06-02
Submitted:2008-06-27
Entered:2008-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 2 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal distension, Abdominal tenderness, Acidosis, Appendicectomy, Convulsion, Dehydration, Diarrhoea, Haematochezia, Hypovolaemic shock, Intussusception, Mucous stools, Pain, Pyrexia, Surgery, Vomiting, Abdominal X-ray, Gastrointestinal sounds abnormal

Life Threatening? Yes
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: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 05Jun2008, see textunit
CDC 'Split Type': B0526485A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 5-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). Previous vaccination included ROTARIX (GlaxoSmithKline); oral given on 5 February 2008. On 14 April 2008 the subject received 2nd dose of ROTARIX (oral). On 2 June 2008, 49 days after vaccination with ROTARIX, the subject experienced high fever (not quantified), loose stools with mucous and blood, and vomiting (unknown number of episodes). Therefore he was treated as outpatient without improvement. On 05 June 2008 the subject presented 3 episodes of generalise seizure, therefore he was hospitalised. Physical examination included bad general conditions, severe dehydration, clinical data of hypovolemic shock with acidosis, abdominal distention, painful at median and deep pressure, peritoneal reaction and abolished peristalsis. Abdominal x-ray showed distended loops and intestinal obstruction. The subject was rehydrated with plan "C" from an organization. The same day the subject underwent a surgery in which intussusception was confirmed. An appendectomy was also done. After surgery the subject evolved to clinical improvement. On 10 June 2008 the subject was discharged in good clinical conditions. Seizure was considered as secondary to fever. No specific studies were done. The subject was hospitalised for 6 days and the physician considered the events were life threatening. The subject was treated with metoclopramide, metronadizole, paracetamol, ampicillin, metamizole, diazepam, amikacin, midazolam, rehydration and surgery.


Changed on 6/14/2018

VAERS ID: 317778 Before After
VAERS Form:1
Age:0.4
Gender:Male
Location:Foreign
Vaccinated:2008-04-14
Onset:2008-06-02
Submitted:2008-06-27
Entered:2008-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 2 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal distension, Abdominal tenderness, Acidosis, Appendicectomy, Convulsion, Dehydration, Diarrhoea, Haematochezia, Hypovolaemic shock, Intussusception, Mucous stools, Pain, Pyrexia, Surgery, Vomiting, Abdominal X-ray, Gastrointestinal sounds abnormal

Life Threatening? Yes
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: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 05Jun2008, see textunit
CDC 'Split Type': B0526485A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 5-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). Previous vaccination included ROTARIX (GlaxoSmithKline); oral given on 5 February 2008. On 14 April 2008 the subject received 2nd dose of ROTARIX (oral). On 2 June 2008, 49 days after vaccination with ROTARIX, the subject experienced high fever (not quantified), loose stools with mucous and blood, and vomiting (unknown number of episodes). Therefore he was treated as outpatient without improvement. On 05 June 2008 the subject presented 3 episodes of generalise seizure, therefore he was hospitalised. Physical examination included bad general conditions, severe dehydration, clinical data of hypovolemic shock with acidosis, abdominal distention, painful at median and deep pressure, peritoneal reaction and abolished peristalsis. Abdominal x-ray showed distended loops and intestinal obstruction. The subject was rehydrated with plan "C" from an organization. The same day the subject underwent a surgery in which intussusception was confirmed. An appendectomy was also done. After surgery the subject evolved to clinical improvement. On 10 June 2008 the subject was discharged in good clinical conditions. Seizure was considered as secondary to fever. No specific studies were done. The subject was hospitalised for 6 days and the physician considered the events were life threatening. The subject was treated with metoclopramide, metronadizole, paracetamol, ampicillin, metamizole, diazepam, amikacin, midazolam, rehydration and surgery.

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