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This is VAERS ID 320743

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 320743
VAERS Form:
Age:0.2
Gender:Female
Location:Foreign
Vaccinated:2008-01-09
Onset:2008-01-15
Submitted:2008-07-30
Entered:2008-07-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Intestinal obstruction, Intussusception, Vomiting, X-ray abnormal, Ultrasound abdomen abnormal, Abdominal X-ray

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Abdominal X-ray, Jan2008, IS; Ultrasound abdomen, Jan2008, IS
CDC 'Split Type': B0530263A

Write-up: This case was reported by a healthcare professional and described the occurrence of intussusception in a 2-month-old female subject who was vaccinated with ROTARIX. This case was collected through the Paediatric Surveillance Unit Acute Intussusception study occurring post Rotavirus vaccination. The subject was born at term. The subject''s birth weight is 3.315Kg. The subject had no family history of intussusception. Feeding history: The subject currently fed formula. The subject received no current treatment. The subject received other vaccines as per schedule. On 9 January 2008, the subject received the 1st dose of ROTARIX (unknown, lot number not provided). On 15 January 2008, 6 days after vaccination with the 1st dose of ROTARIX, the subject was admitted at hospital due to intussusception. The subject experienced intestinal obstruction, bile stained vomiting and vomiting. No faeces sample was collected. The diagnosis of intussusception was made based on abdominal ultrasound exam and abdominal X-ray. Intussusception had spontaneously reverted. At the time of reporting the outcome of the events was unspecified.


Changed on 5/13/2013

VAERS ID: 320743 Before After
VAERS Form:
Age:0.2
Gender:Female
Location:Foreign
Vaccinated:2008-01-09
Onset:2008-01-15
Submitted:2008-07-30
Entered:2008-07-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - UN / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Intestinal obstruction, Intussusception, Vomiting, X-ray abnormal, Ultrasound abdomen abnormal, Abdominal X-ray

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Abdominal X-ray, Jan2008, IS; Ultrasound abdomen, Jan2008, IS
CDC 'Split Type': B0530263A

Write-up: This case was reported by a healthcare professional and described the occurrence of intussusception in a 2-month-old female subject who was vaccinated with ROTARIX. This case was collected through the Paediatric Surveillance Unit Acute Intussusception study occurring post Rotavirus vaccination. The subject was born at term. The subject''s birth weight is 3.315Kg. The subject had no family history of intussusception. Feeding history: The subject currently fed formula. The subject received no current treatment. The subject received other vaccines as per schedule. On 9 January 2008, the subject received the 1st dose of ROTARIX (unknown, lot number not provided). On 15 January 2008, 6 days after vaccination with the 1st dose of ROTARIX, the subject was admitted at hospital due to intussusception. The subject experienced intestinal obstruction, bile stained vomiting and vomiting. No faeces sample was collected. The diagnosis of intussusception was made based on abdominal ultrasound exam and abdominal X-ray. Intussusception had spontaneously reverted. At the time of reporting the outcome of the events was unspecified.


Changed on 9/14/2017

VAERS ID: 320743 Before After
VAERS Form:(blank) 1
Age:0.2
Gender:Female
Location:Foreign
Vaccinated:2008-01-09
Onset:2008-01-15
Submitted:2008-07-30
Entered:2008-07-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Intestinal obstruction, Intussusception, Vomiting, X-ray abnormal, Ultrasound abdomen abnormal, Abdominal X-ray

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Abdominal X-ray, Jan2008, IS; Ultrasound abdomen, Jan2008, IS
CDC 'Split Type': B0530263A

Write-up: This case was reported by a healthcare professional and described the occurrence of intussusception in a 2-month-old female subject who was vaccinated with ROTARIX. This case was collected through the Paediatric Surveillance Unit Acute Intussusception study occurring post Rotavirus vaccination. The subject was born at term. The subject''s birth weight is 3.315Kg. The subject had no family history of intussusception. Feeding history: The subject currently fed formula. The subject received no current treatment. The subject received other vaccines as per schedule. On 9 January 2008, the subject received the 1st dose of ROTARIX (unknown, lot number not provided). On 15 January 2008, 6 days after vaccination with the 1st dose of ROTARIX, the subject was admitted at hospital due to intussusception. The subject experienced intestinal obstruction, bile stained vomiting and vomiting. No faeces sample was collected. The diagnosis of intussusception was made based on abdominal ultrasound exam and abdominal X-ray. Intussusception had spontaneously reverted. At the time of reporting the outcome of the events was unspecified.


Changed on 2/14/2018

VAERS ID: 320743 Before After
VAERS Form:1
Age:0.2
Gender:Female
Location:Foreign
Vaccinated:2008-01-09
Onset:2008-01-15
Submitted:2008-07-30
Entered:2008-07-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Intestinal obstruction, Intussusception, Vomiting, X-ray abnormal, Ultrasound abdomen abnormal, Abdominal X-ray

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Abdominal X-ray, Jan2008, IS; Ultrasound abdomen, Jan2008, IS
CDC 'Split Type': B0530263A

Write-up: This case was reported by a healthcare professional and described the occurrence of intussusception in a 2-month-old female subject who was vaccinated with ROTARIX. This case was collected through the Paediatric Surveillance Unit Acute Intussusception study occurring post Rotavirus vaccination. The subject was born at term. The subject''s birth weight is 3.315Kg. The subject had no family history of intussusception. Feeding history: The subject currently fed formula. The subject received no current treatment. The subject received other vaccines as per schedule. On 9 January 2008, the subject received the 1st dose of ROTARIX (unknown, lot number not provided). On 15 January 2008, 6 days after vaccination with the 1st dose of ROTARIX, the subject was admitted at hospital due to intussusception. The subject experienced intestinal obstruction, bile stained vomiting and vomiting. No faeces sample was collected. The diagnosis of intussusception was made based on abdominal ultrasound exam and abdominal X-ray. Intussusception had spontaneously reverted. At the time of reporting the outcome of the events was unspecified.


Changed on 6/14/2018

VAERS ID: 320743 Before After
VAERS Form:1
Age:0.2
Gender:Female
Location:Foreign
Vaccinated:2008-01-09
Onset:2008-01-15
Submitted:2008-07-30
Entered:2008-07-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Intestinal obstruction, Intussusception, Vomiting, X-ray abnormal, Ultrasound abdomen abnormal, Abdominal X-ray

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Abdominal X-ray, Jan2008, IS; Ultrasound abdomen, Jan2008, IS
CDC 'Split Type': B0530263A

Write-up: This case was reported by a healthcare professional and described the occurrence of intussusception in a 2-month-old female subject who was vaccinated with ROTARIX. This case was collected through the Paediatric Surveillance Unit Acute Intussusception study occurring post Rotavirus vaccination. The subject was born at term. The subject''s birth weight is 3.315Kg. The subject had no family history of intussusception. Feeding history: The subject currently fed formula. The subject received no current treatment. The subject received other vaccines as per schedule. On 9 January 2008, the subject received the 1st dose of ROTARIX (unknown, lot number not provided). On 15 January 2008, 6 days after vaccination with the 1st dose of ROTARIX, the subject was admitted at hospital due to intussusception. The subject experienced intestinal obstruction, bile stained vomiting and vomiting. No faeces sample was collected. The diagnosis of intussusception was made based on abdominal ultrasound exam and abdominal X-ray. Intussusception had spontaneously reverted. At the time of reporting the outcome of the events was unspecified.


Changed on 8/14/2018

VAERS ID: 320743 Before After
VAERS Form:1
Age:0.2
Gender:Female
Location:Foreign
Vaccinated:2008-01-09
Onset:2008-01-15
Submitted:2008-07-30
Entered:2008-07-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Intestinal obstruction, Intussusception, Vomiting, X-ray abnormal, Ultrasound abdomen abnormal, Abdominal X-ray

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Abdominal X-ray, Jan2008, IS; Ultrasound abdomen, Jan2008, IS
CDC 'Split Type': B0530263A

Write-up: This case was reported by a healthcare professional and described the occurrence of intussusception in a 2-month-old female subject who was vaccinated with ROTARIX. This case was collected through the Paediatric Surveillance Unit Acute Intussusception study occurring post Rotavirus vaccination. The subject was born at term. The subject''s birth weight is 3.315Kg. The subject had no family history of intussusception. Feeding history: The subject currently fed formula. The subject received no current treatment. The subject received other vaccines as per schedule. On 9 January 2008, the subject received the 1st dose of ROTARIX (unknown, lot number not provided). On 15 January 2008, 6 days after vaccination with the 1st dose of ROTARIX, the subject was admitted at hospital due to intussusception. The subject experienced intestinal obstruction, bile stained vomiting and vomiting. No faeces sample was collected. The diagnosis of intussusception was made based on abdominal ultrasound exam and abdominal X-ray. Intussusception had spontaneously reverted. At the time of reporting the outcome of the events was unspecified.


Changed on 9/14/2018

VAERS ID: 320743 Before After
VAERS Form:1
Age:0.2
Gender:Female
Location:Foreign
Vaccinated:2008-01-09
Onset:2008-01-15
Submitted:2008-07-30
Entered:2008-07-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Intestinal obstruction, Intussusception, Vomiting, X-ray abnormal, Ultrasound abdomen abnormal, Abdominal X-ray

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Abdominal X-ray, Jan2008, IS; Ultrasound abdomen, Jan2008, IS
CDC 'Split Type': B0530263A

Write-up: This case was reported by a healthcare professional and described the occurrence of intussusception in a 2-month-old female subject who was vaccinated with ROTARIX. This case was collected through the Paediatric Surveillance Unit Acute Intussusception study occurring post Rotavirus vaccination. The subject was born at term. The subject''s birth weight is 3.315Kg. The subject had no family history of intussusception. Feeding history: The subject currently fed formula. The subject received no current treatment. The subject received other vaccines as per schedule. On 9 January 2008, the subject received the 1st dose of ROTARIX (unknown, lot number not provided). On 15 January 2008, 6 days after vaccination with the 1st dose of ROTARIX, the subject was admitted at hospital due to intussusception. The subject experienced intestinal obstruction, bile stained vomiting and vomiting. No faeces sample was collected. The diagnosis of intussusception was made based on abdominal ultrasound exam and abdominal X-ray. Intussusception had spontaneously reverted. At the time of reporting the outcome of the events was unspecified.

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