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This is VAERS ID 320289

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 320289
VAERS Form:
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-05-13
Onset:2008-05-16
Submitted:2008-07-23
Entered:2008-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 0 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Barium enema, Constipation, Haematochezia, Intussusception, Irritability, Malaise, Pallor, Vomiting, 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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0529692A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of ileocolic intussusception in a 4-year-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject was on no other medication and had no relevant medical history of allergy. On 13 May 2008, the subject received 1st dose of ROTARIX (oral, lot number not provided). On 16 May 2008, 3 days after vaccination with ROTARIX, the subject started with irritability, vomiting, constipation and malaise. On 18 May 2008, 5 days after vaccination with ROTARIX, the subject experienced bloody stools and he was hospitalized. The physical exam showed pallor, abdominal pain and bowel sounds increased. Barited enema was done on 18 May 2008 and showed ileocolic intussusception in transverse colon and reduction with pass through ileocaecal valve to ileon with success. The patient had good evolution and recuperation. The subject was discharged of emergency room on 18 May 2008 in good clinical conditions and pass to pediatric service for clinical observation. The date of hospitalization discharge was not available. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 5/13/2013

VAERS ID: 320289 Before After
VAERS Form:
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-05-13
Onset:2008-05-16
Submitted:2008-07-23
Entered:2008-07-23
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, Barium enema, Constipation, Haematochezia, Intussusception, Irritability, Malaise, Pallor, Vomiting, 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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0529692A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of ileocolic intussusception in a 4-year-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject was on no other medication and had no relevant medical history of allergy. On 13 May 2008, the subject received 1st dose of ROTARIX (oral, lot number not provided). On 16 May 2008, 3 days after vaccination with ROTARIX, the subject started with irritability, vomiting, constipation and malaise. On 18 May 2008, 5 days after vaccination with ROTARIX, the subject experienced bloody stools and he was hospitalized. The physical exam showed pallor, abdominal pain and bowel sounds increased. Barited enema was done on 18 May 2008 and showed ileocolic intussusception in transverse colon and reduction with pass through ileocaecal valve to ileon with success. The patient had good evolution and recuperation. The subject was discharged of emergency room on 18 May 2008 in good clinical conditions and pass to pediatric service for clinical observation. The date of hospitalization discharge was not available. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 9/14/2017

VAERS ID: 320289 Before After
VAERS Form:(blank) 1
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-05-13
Onset:2008-05-16
Submitted:2008-07-23
Entered:2008-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 0 1 - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Barium enema, Constipation, Haematochezia, Intussusception, Irritability, Malaise, Pallor, Vomiting, 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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0529692A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of ileocolic intussusception in a 4-year-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject was on no other medication and had no relevant medical history of allergy. On 13 May 2008, the subject received 1st dose of ROTARIX (oral, lot number not provided). On 16 May 2008, 3 days after vaccination with ROTARIX, the subject started with irritability, vomiting, constipation and malaise. On 18 May 2008, 5 days after vaccination with ROTARIX, the subject experienced bloody stools and he was hospitalized. The physical exam showed pallor, abdominal pain and bowel sounds increased. Barited enema was done on 18 May 2008 and showed ileocolic intussusception in transverse colon and reduction with pass through ileocaecal valve to ileon with success. The patient had good evolution and recuperation. The subject was discharged of emergency room on 18 May 2008 in good clinical conditions and pass to pediatric service for clinical observation. The date of hospitalization discharge was not available. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 2/14/2018

VAERS ID: 320289 Before After
VAERS Form:1
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-05-13
Onset:2008-05-16
Submitted:2008-07-23
Entered:2008-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Barium enema, Constipation, Haematochezia, Intussusception, Irritability, Malaise, Pallor, Vomiting, 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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0529692A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of ileocolic intussusception in a 4-year-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject was on no other medication and had no relevant medical history of allergy. On 13 May 2008, the subject received 1st dose of ROTARIX (oral, lot number not provided). On 16 May 2008, 3 days after vaccination with ROTARIX, the subject started with irritability, vomiting, constipation and malaise. On 18 May 2008, 5 days after vaccination with ROTARIX, the subject experienced bloody stools and he was hospitalized. The physical exam showed pallor, abdominal pain and bowel sounds increased. Barited enema was done on 18 May 2008 and showed ileocolic intussusception in transverse colon and reduction with pass through ileocaecal valve to ileon with success. The patient had good evolution and recuperation. The subject was discharged of emergency room on 18 May 2008 in good clinical conditions and pass to pediatric service for clinical observation. The date of hospitalization discharge was not available. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 6/14/2018

VAERS ID: 320289 Before After
VAERS Form:1
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-05-13
Onset:2008-05-16
Submitted:2008-07-23
Entered:2008-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Barium enema, Constipation, Haematochezia, Intussusception, Irritability, Malaise, Pallor, Vomiting, 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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0529692A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of ileocolic intussusception in a 4-year-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject was on no other medication and had no relevant medical history of allergy. On 13 May 2008, the subject received 1st dose of ROTARIX (oral, lot number not provided). On 16 May 2008, 3 days after vaccination with ROTARIX, the subject started with irritability, vomiting, constipation and malaise. On 18 May 2008, 5 days after vaccination with ROTARIX, the subject experienced bloody stools and he was hospitalized. The physical exam showed pallor, abdominal pain and bowel sounds increased. Barited enema was done on 18 May 2008 and showed ileocolic intussusception in transverse colon and reduction with pass through ileocaecal valve to ileon with success. The patient had good evolution and recuperation. The subject was discharged of emergency room on 18 May 2008 in good clinical conditions and pass to pediatric service for clinical observation. The date of hospitalization discharge was not available. The physician considered the events were possibly related to vaccination with ROTARIX.

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