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This is VAERS ID 319089

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

319089
VAERS Form:
Age:0.2
Gender:Male
Location:Foreign
Vaccinated:2008-02-07
Onset:2008-04-01
Submitted:2008-07-15
Entered:2008-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 0 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal distension, Activated partial thromboplastin time shortened, Cardiac murmur, Cough, Dehydration, Diarrhoea, Haematochezia, Intestinal obstruction, Intussusception, Irritability, Malaise, Pain, Prothrombin time shortened, Pyrexia, Surgery, Vomiting, X-ray abnormal, Neutrophil percentage, Abdominal X-ray, Tympanic membrane disorder, 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: 8     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 05Apr2008, see text; Neutrophils, 05Apr2008, 67%; Partial prothrombin time, 05Apr2008, 28sec; Prothrombin time, 05Apr2008, 10sec
CDC 'Split Type': B0528920A

Write-up:This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 4-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject was on no other medication and had no relevant medical history or allergy. On 7 February 2008, the subject received 1st dose of ROTARIX (oral). Not number not provided. On 1 April 2008, 54 days after vaccination with ROTARIX, the subject presented malaise, fever, irritability, diarrhea, cough, vomiting. On 4 April 2008, the patient experienced bloody stools and abdominal distention. The subject was hospitalized. Physical exam was performed on 5 April 2008 and showed dehydration, fever, irritability, mesocardic systolic murmur, distended abdomen, tympanic, painfulness and diminished bowel sounds. Rectal tact with empty ampulla and "sanguinolent" stools. Abdominal X-ray was performed on 5 April 2008 and showed image like intestinal obstruction with dilated small bowel and colon. Laboratory tests performed on 5 April 2008 showed the following: Neutrophils: 67%, prothrombin time: 10 sec, partial prothrombin time: 28 sec. Ileocaecal intussusception was confirmed by surgery on 5 April 2008 and resolved by taxis. The subject was treated with amikacin, metronadizole, ranitidine, metamizole, ketorolac and paracetamol. The subject evolved to clinical improvement and was discharged on 12 April 2008. On 12 April 2008, the events were resolved. The physician considered the events were unrelated to vaccination with ROTARIX.


Changed on 5/13/2013

319089 Before After
VAERS Form:
Age:0.2
Gender:Male
Location:Foreign
Vaccinated:2008-02-07
Onset:2008-04-01
Submitted:2008-07-15
Entered:2008-07-15
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 distension, Activated partial thromboplastin time shortened, Cardiac murmur, Cough, Dehydration, Diarrhoea, Haematochezia, Intestinal obstruction, Intussusception, Irritability, Malaise, Pain, Prothrombin time shortened, Pyrexia, Surgery, Vomiting, X-ray abnormal, Neutrophil percentage, Abdominal X-ray, Tympanic membrane disorder, 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: 8     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 05Apr2008, see text; Neutrophils, 05Apr2008, 67%; Partial prothrombin time, 05Apr2008, 28sec; Prothrombin time, 05Apr2008, 10sec
CDC 'Split Type': B0528920A

Write-up:This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 4-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject was on no other medication and had no relevant medical history or allergy. On 7 February 2008, the subject received 1st dose of ROTARIX (oral). Not number not provided. On 1 April 2008, 54 days after vaccination with ROTARIX, the subject presented malaise, fever, irritability, diarrhea, cough, vomiting. On 4 April 2008, the patient experienced bloody stools and abdominal distention. The subject was hospitalized. Physical exam was performed on 5 April 2008 and showed dehydration, fever, irritability, mesocardic systolic murmur, distended abdomen, tympanic, painfulness and diminished bowel sounds. Rectal tact with empty ampulla and "sanguinolent" stools. Abdominal X-ray was performed on 5 April 2008 and showed image like intestinal obstruction with dilated small bowel and colon. Laboratory tests performed on 5 April 2008 showed the following: Neutrophils: 67%, prothrombin time: 10 sec, partial prothrombin time: 28 sec. Ileocaecal intussusception was confirmed by surgery on 5 April 2008 and resolved by taxis. The subject was treated with amikacin, metronadizole, ranitidine, metamizole, ketorolac and paracetamol. The subject evolved to clinical improvement and was discharged on 12 April 2008. On 12 April 2008, the events were resolved. The physician considered the events were unrelated to vaccination with ROTARIX.


Changed on 9/14/2017

319089 Before After
VAERS Form:(blank) 1
Age:0.2
Gender:Male
Location:Foreign
Vaccinated:2008-02-07
Onset:2008-04-01
Submitted:2008-07-15
Entered:2008-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 0 1 - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal distension, Activated partial thromboplastin time shortened, Cardiac murmur, Cough, Dehydration, Diarrhoea, Haematochezia, Intestinal obstruction, Intussusception, Irritability, Malaise, Pain, Prothrombin time shortened, Pyrexia, Surgery, Vomiting, X-ray abnormal, Neutrophil percentage, Abdominal X-ray, Tympanic membrane disorder, 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: 8     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 05Apr2008, see text; Neutrophils, 05Apr2008, 67%; Partial prothrombin time, 05Apr2008, 28sec; Prothrombin time, 05Apr2008, 10sec
CDC 'Split Type': B0528920A

Write-up:This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 4-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject was on no other medication and had no relevant medical history or allergy. On 7 February 2008, the subject received 1st dose of ROTARIX (oral). Not number not provided. On 1 April 2008, 54 days after vaccination with ROTARIX, the subject presented malaise, fever, irritability, diarrhea, cough, vomiting. On 4 April 2008, the patient experienced bloody stools and abdominal distention. The subject was hospitalized. Physical exam was performed on 5 April 2008 and showed dehydration, fever, irritability, mesocardic systolic murmur, distended abdomen, tympanic, painfulness and diminished bowel sounds. Rectal tact with empty ampulla and "sanguinolent" stools. Abdominal X-ray was performed on 5 April 2008 and showed image like intestinal obstruction with dilated small bowel and colon. Laboratory tests performed on 5 April 2008 showed the following: Neutrophils: 67%, prothrombin time: 10 sec, partial prothrombin time: 28 sec. Ileocaecal intussusception was confirmed by surgery on 5 April 2008 and resolved by taxis. The subject was treated with amikacin, metronadizole, ranitidine, metamizole, ketorolac and paracetamol. The subject evolved to clinical improvement and was discharged on 12 April 2008. On 12 April 2008, the events were resolved. The physician considered the events were unrelated to vaccination with ROTARIX.


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