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This is VAERS ID 320508

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 320508
VAERS Form:
Age:0.4
Gender:Male
Location:Foreign
Vaccinated:2008-02-22
Onset:2008-06-30
Submitted:2008-07-25
Entered:2008-07-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Anorexia, Appendicectomy, Cough, Decreased activity, Dehydration, Haematochezia, Intussusception, Irritability, Pallor, Pyrexia, Rhinorrhoea, Tachycardia, Vomiting, Pharmaceutical product complaint, Gastrointestinal hypomotility, Intestinal malrotation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Upper respiratory tract infection
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0530419A

Write-up: This case was reported by a physician in the frame of a PASS study and described the occurrence of intussusception in a 9-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). Concurrent medical conditions included upper respiratory tract infection on 30 June 2008 but no more information was available in the chart. Concurrent vaccination included ROTARIX (GlaxoSmithKline) given on 22 November 2007. On 22 February 2008, the subject received 2nd dose of ROTARIX (1 ml, oral). Lot number not provided. On 30 June 008, 4 months after vaccinations with RORTARIX, the subject started with fever, clear rhinorrhea, cough, 3 bloody stools, vomiting, irritability, hyporexia and abdominal pain. the subject was admitted to emergency room on 30 June 2008 with fever, pallor, pharyngeal congestion, mild dehydration, tachycardia, hypoactive, abdominal pain in the pelvic fore, decreased gastrointestinal peristalsis, positive dance sign and rectal tact with expulsion of current jelly stool. Surgery was done on 30 June 2008: ileo-ileal intussusception with intestinal malrotation was found, corrected by taxis without intestinal resection; prophylactic appendectomy was done without complications. The subject was hospitalized for 3 days. Laboratory exams and X-rays results were not available in the clinical chart. The subject was treated with metronidazole, AMIKACINE, METAMIZOLE, RANITIDINE, metoclopramide and paracetamol. Post surgical evolution was favorable. On 2 July 2008, the subject was discharged with good clinical recuperation. The physician considered the events were unrelated to vaccination with ROTARIX.


Changed on 5/13/2013

VAERS ID: 320508 Before After
VAERS Form:
Age:0.4
Gender:Male
Location:Foreign
Vaccinated:2008-02-22
Onset:2008-06-30
Submitted:2008-07-25
Entered:2008-07-25
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, Anorexia, Appendicectomy, Cough, Decreased activity, Dehydration, Haematochezia, Intussusception, Irritability, Pallor, Pyrexia, Rhinorrhoea, Tachycardia, Vomiting, Pharmaceutical product complaint, Gastrointestinal hypomotility, Intestinal malrotation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Upper respiratory tract infection
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0530419A

Write-up: This case was reported by a physician in the frame of a PASS study and described the occurrence of intussusception in a 9-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). Concurrent medical conditions included upper respiratory tract infection on 30 June 2008 but no more information was available in the chart. Concurrent vaccination included ROTARIX (GlaxoSmithKline) given on 22 November 2007. On 22 February 2008, the subject received 2nd dose of ROTARIX (1 ml, oral). Lot number not provided. On 30 June 008, 4 months after vaccinations with RORTARIX, the subject started with fever, clear rhinorrhea, cough, 3 bloody stools, vomiting, irritability, hyporexia and abdominal pain. the subject was admitted to emergency room on 30 June 2008 with fever, pallor, pharyngeal congestion, mild dehydration, tachycardia, hypoactive, abdominal pain in the pelvic fore, decreased gastrointestinal peristalsis, positive dance sign and rectal tact with expulsion of current jelly stool. Surgery was done on 30 June 2008: ileo-ileal intussusception with intestinal malrotation was found, corrected by taxis without intestinal resection; prophylactic appendectomy was done without complications. The subject was hospitalized for 3 days. Laboratory exams and X-rays results were not available in the clinical chart. The subject was treated with metronidazole, AMIKACINE, METAMIZOLE, RANITIDINE, metoclopramide and paracetamol. Post surgical evolution was favorable. On 2 July 2008, the subject was discharged with good clinical recuperation. The physician considered the events were unrelated to vaccination with ROTARIX.


Changed on 9/14/2017

VAERS ID: 320508 Before After
VAERS Form:(blank) 1
Age:0.4
Gender:Male
Location:Foreign
Vaccinated:2008-02-22
Onset:2008-06-30
Submitted:2008-07-25
Entered:2008-07-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - UNK - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Anorexia, Appendicectomy, Cough, Decreased activity, Dehydration, Haematochezia, Intussusception, Irritability, Pallor, Pyrexia, Rhinorrhoea, Tachycardia, Vomiting, Pharmaceutical product complaint, Gastrointestinal hypomotility, Intestinal malrotation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Upper respiratory tract infection
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0530419A

Write-up: This case was reported by a physician in the frame of a PASS study and described the occurrence of intussusception in a 9-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). Concurrent medical conditions included upper respiratory tract infection on 30 June 2008 but no more information was available in the chart. Concurrent vaccination included ROTARIX (GlaxoSmithKline) given on 22 November 2007. On 22 February 2008, the subject received 2nd dose of ROTARIX (1 ml, oral). Lot number not provided. On 30 June 008, 4 months after vaccinations with RORTARIX, the subject started with fever, clear rhinorrhea, cough, 3 bloody stools, vomiting, irritability, hyporexia and abdominal pain. the subject was admitted to emergency room on 30 June 2008 with fever, pallor, pharyngeal congestion, mild dehydration, tachycardia, hypoactive, abdominal pain in the pelvic fore, decreased gastrointestinal peristalsis, positive dance sign and rectal tact with expulsion of current jelly stool. Surgery was done on 30 June 2008: ileo-ileal intussusception with intestinal malrotation was found, corrected by taxis without intestinal resection; prophylactic appendectomy was done without complications. The subject was hospitalized for 3 days. Laboratory exams and X-rays results were not available in the clinical chart. The subject was treated with metronidazole, AMIKACINE, METAMIZOLE, RANITIDINE, metoclopramide and paracetamol. Post surgical evolution was favorable. On 2 July 2008, the subject was discharged with good clinical recuperation. The physician considered the events were unrelated to vaccination with ROTARIX.


Changed on 2/14/2018

VAERS ID: 320508 Before After
VAERS Form:1
Age:0.4
Gender:Male
Location:Foreign
Vaccinated:2008-02-22
Onset:2008-06-30
Submitted:2008-07-25
Entered:2008-07-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Anorexia, Appendicectomy, Cough, Decreased activity, Dehydration, Haematochezia, Intussusception, Irritability, Pallor, Pyrexia, Rhinorrhoea, Tachycardia, Vomiting, Pharmaceutical product complaint, Gastrointestinal hypomotility, Intestinal malrotation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Upper respiratory tract infection
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0530419A

Write-up: This case was reported by a physician in the frame of a PASS study and described the occurrence of intussusception in a 9-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). Concurrent medical conditions included upper respiratory tract infection on 30 June 2008 but no more information was available in the chart. Concurrent vaccination included ROTARIX (GlaxoSmithKline) given on 22 November 2007. On 22 February 2008, the subject received 2nd dose of ROTARIX (1 ml, oral). Lot number not provided. On 30 June 008, 4 months after vaccinations with RORTARIX, the subject started with fever, clear rhinorrhea, cough, 3 bloody stools, vomiting, irritability, hyporexia and abdominal pain. the subject was admitted to emergency room on 30 June 2008 with fever, pallor, pharyngeal congestion, mild dehydration, tachycardia, hypoactive, abdominal pain in the pelvic fore, decreased gastrointestinal peristalsis, positive dance sign and rectal tact with expulsion of current jelly stool. Surgery was done on 30 June 2008: ileo-ileal intussusception with intestinal malrotation was found, corrected by taxis without intestinal resection; prophylactic appendectomy was done without complications. The subject was hospitalized for 3 days. Laboratory exams and X-rays results were not available in the clinical chart. The subject was treated with metronidazole, AMIKACINE, METAMIZOLE, RANITIDINE, metoclopramide and paracetamol. Post surgical evolution was favorable. On 2 July 2008, the subject was discharged with good clinical recuperation. The physician considered the events were unrelated to vaccination with ROTARIX.


Changed on 6/14/2018

VAERS ID: 320508 Before After
VAERS Form:1
Age:0.4
Gender:Male
Location:Foreign
Vaccinated:2008-02-22
Onset:2008-06-30
Submitted:2008-07-25
Entered:2008-07-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Anorexia, Appendicectomy, Cough, Decreased activity, Dehydration, Haematochezia, Intussusception, Irritability, Pallor, Pyrexia, Rhinorrhoea, Tachycardia, Vomiting, Pharmaceutical product complaint, Gastrointestinal hypomotility, Intestinal malrotation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Upper respiratory tract infection
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0530419A

Write-up: This case was reported by a physician in the frame of a PASS study and described the occurrence of intussusception in a 9-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). Concurrent medical conditions included upper respiratory tract infection on 30 June 2008 but no more information was available in the chart. Concurrent vaccination included ROTARIX (GlaxoSmithKline) given on 22 November 2007. On 22 February 2008, the subject received 2nd dose of ROTARIX (1 ml, oral). Lot number not provided. On 30 June 008, 4 months after vaccinations with RORTARIX, the subject started with fever, clear rhinorrhea, cough, 3 bloody stools, vomiting, irritability, hyporexia and abdominal pain. the subject was admitted to emergency room on 30 June 2008 with fever, pallor, pharyngeal congestion, mild dehydration, tachycardia, hypoactive, abdominal pain in the pelvic fore, decreased gastrointestinal peristalsis, positive dance sign and rectal tact with expulsion of current jelly stool. Surgery was done on 30 June 2008: ileo-ileal intussusception with intestinal malrotation was found, corrected by taxis without intestinal resection; prophylactic appendectomy was done without complications. The subject was hospitalized for 3 days. Laboratory exams and X-rays results were not available in the clinical chart. The subject was treated with metronidazole, AMIKACINE, METAMIZOLE, RANITIDINE, metoclopramide and paracetamol. Post surgical evolution was favorable. On 2 July 2008, the subject was discharged with good clinical recuperation. The physician considered the events were unrelated to vaccination with ROTARIX.


Changed on 8/14/2018

VAERS ID: 320508 Before After
VAERS Form:1
Age:0.4
Gender:Male
Location:Foreign
Vaccinated:2008-02-22
Onset:2008-06-30
Submitted:2008-07-25
Entered:2008-07-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Anorexia, Appendicectomy, Cough, Decreased activity, Dehydration, Haematochezia, Intussusception, Irritability, Pallor, Pyrexia, Rhinorrhoea, Tachycardia, Vomiting, Pharmaceutical product complaint, Gastrointestinal hypomotility, Intestinal malrotation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Upper respiratory tract infection
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0530419A

Write-up: This case was reported by a physician in the frame of a PASS study and described the occurrence of intussusception in a 9-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). Concurrent medical conditions included upper respiratory tract infection on 30 June 2008 but no more information was available in the chart. Concurrent vaccination included ROTARIX (GlaxoSmithKline) given on 22 November 2007. On 22 February 2008, the subject received 2nd dose of ROTARIX (1 ml, oral). Lot number not provided. On 30 June 008, 4 months after vaccinations with RORTARIX, the subject started with fever, clear rhinorrhea, cough, 3 bloody stools, vomiting, irritability, hyporexia and abdominal pain. the subject was admitted to emergency room on 30 June 2008 with fever, pallor, pharyngeal congestion, mild dehydration, tachycardia, hypoactive, abdominal pain in the pelvic fore, decreased gastrointestinal peristalsis, positive dance sign and rectal tact with expulsion of current jelly stool. Surgery was done on 30 June 2008: ileo-ileal intussusception with intestinal malrotation was found, corrected by taxis without intestinal resection; prophylactic appendectomy was done without complications. The subject was hospitalized for 3 days. Laboratory exams and X-rays results were not available in the clinical chart. The subject was treated with metronidazole, AMIKACINE, METAMIZOLE, RANITIDINE, metoclopramide and paracetamol. Post surgical evolution was favorable. On 2 July 2008, the subject was discharged with good clinical recuperation. The physician considered the events were unrelated to vaccination with ROTARIX.


Changed on 9/14/2018

VAERS ID: 320508 Before After
VAERS Form:1
Age:0.4
Gender:Male
Location:Foreign
Vaccinated:2008-02-22
Onset:2008-06-30
Submitted:2008-07-25
Entered:2008-07-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Anorexia, Appendicectomy, Cough, Decreased activity, Dehydration, Haematochezia, Intussusception, Irritability, Pallor, Pyrexia, Rhinorrhoea, Tachycardia, Vomiting, Pharmaceutical product complaint, Gastrointestinal hypomotility, Intestinal malrotation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Upper respiratory tract infection
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0530419A

Write-up: This case was reported by a physician in the frame of a PASS study and described the occurrence of intussusception in a 9-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). Concurrent medical conditions included upper respiratory tract infection on 30 June 2008 but no more information was available in the chart. Concurrent vaccination included ROTARIX (GlaxoSmithKline) given on 22 November 2007. On 22 February 2008, the subject received 2nd dose of ROTARIX (1 ml, oral). Lot number not provided. On 30 June 008, 4 months after vaccinations with RORTARIX, the subject started with fever, clear rhinorrhea, cough, 3 bloody stools, vomiting, irritability, hyporexia and abdominal pain. the subject was admitted to emergency room on 30 June 2008 with fever, pallor, pharyngeal congestion, mild dehydration, tachycardia, hypoactive, abdominal pain in the pelvic fore, decreased gastrointestinal peristalsis, positive dance sign and rectal tact with expulsion of current jelly stool. Surgery was done on 30 June 2008: ileo-ileal intussusception with intestinal malrotation was found, corrected by taxis without intestinal resection; prophylactic appendectomy was done without complications. The subject was hospitalized for 3 days. Laboratory exams and X-rays results were not available in the clinical chart. The subject was treated with metronidazole, AMIKACINE, METAMIZOLE, RANITIDINE, metoclopramide and paracetamol. Post surgical evolution was favorable. On 2 July 2008, the subject was discharged with good clinical recuperation. The physician considered the events were unrelated to vaccination with ROTARIX.


Changed on 10/14/2018

VAERS ID: 320508 Before After
VAERS Form:1
Age:0.4
Gender:Male
Location:Foreign
Vaccinated:2008-02-22
Onset:2008-06-30
Submitted:2008-07-25
Entered:2008-07-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Anorexia, Appendicectomy, Cough, Decreased activity, Dehydration, Haematochezia, Intussusception, Irritability, Pallor, Pyrexia, Rhinorrhoea, Tachycardia, Vomiting, Pharmaceutical product complaint, Gastrointestinal hypomotility, Intestinal malrotation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Upper respiratory tract infection
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0530419A

Write-up: This case was reported by a physician in the frame of a PASS study and described the occurrence of intussusception in a 9-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). Concurrent medical conditions included upper respiratory tract infection on 30 June 2008 but no more information was available in the chart. Concurrent vaccination included ROTARIX (GlaxoSmithKline) given on 22 November 2007. On 22 February 2008, the subject received 2nd dose of ROTARIX (1 ml, oral). Lot number not provided. On 30 June 008, 4 months after vaccinations with RORTARIX, the subject started with fever, clear rhinorrhea, cough, 3 bloody stools, vomiting, irritability, hyporexia and abdominal pain. the subject was admitted to emergency room on 30 June 2008 with fever, pallor, pharyngeal congestion, mild dehydration, tachycardia, hypoactive, abdominal pain in the pelvic fore, decreased gastrointestinal peristalsis, positive dance sign and rectal tact with expulsion of current jelly stool. Surgery was done on 30 June 2008: ileo-ileal intussusception with intestinal malrotation was found, corrected by taxis without intestinal resection; prophylactic appendectomy was done without complications. The subject was hospitalized for 3 days. Laboratory exams and X-rays results were not available in the clinical chart. The subject was treated with metronidazole, AMIKACINE, METAMIZOLE, RANITIDINE, metoclopramide and paracetamol. Post surgical evolution was favorable. On 2 July 2008, the subject was discharged with good clinical recuperation. The physician considered the events were unrelated to vaccination with ROTARIX.

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