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This is VAERS ID 320744

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 320744
VAERS Form:
Age:0.4
Gender:Female
Location:Foreign
Vaccinated:2008-05-13
Onset:2008-05-17
Submitted:2008-07-30
Entered:2008-07-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Lethargy, Rectal haemorrhage, Vomiting, Enema administration

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: Unknown
CDC 'Split Type': B0530264A

Write-up: This case was reported by a healthcare professional and described the occurrence of intussusception in a 4-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). This case was collected through the foreign Surveillance Unit Acute Intussusception study occurring post Rotavirus vaccination. The subject was born at term. The subject''s birth weight is 3.39Kg. The subject had no history of intussusception. The subject had no previous significant illness/hospitalisations/operations. Feeding history: The subject currently fed formula. Until the age of 3 months the subject was exclusively breastfed. There was a change to the subject''s diet in the last week (change to formula). The subject had no feeding intolerance or food sensitivities. The subject received no current treatment. The subject received other vaccines as per schedule. Previous vaccination included ROTARIX (GlaxoSmithKline) given on 19 March 2008. On 13 May 2008, the subject received the 2nd dose of ROTARIX (unknown). On 17 May 2008, 4 days after vaccination with the 2nd dose of ROTARIX, the subject was admitted at hospital due to intussusception. The subject experienced passage of blood per rectum, vomiting and lethargy. No faeces sample was collected. The diagnosis of intussusception was made based on Enema (Site of intussusception: sigmoid colon). The subject was treated with guided fluoroscopy Enema. On 18 May 2008, the subject was discharged alive. At the time of reporting the outcome of the events was unspecified.


Changed on 5/13/2013

VAERS ID: 320744 Before After
VAERS Form:
Age:0.4
Gender:Female
Location:Foreign
Vaccinated:2008-05-13
Onset:2008-05-17
Submitted:2008-07-30
Entered:2008-07-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 UN / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Lethargy, Rectal haemorrhage, Vomiting, Enema administration

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: Unknown
CDC 'Split Type': B0530264A

Write-up: This case was reported by a healthcare professional and described the occurrence of intussusception in a 4-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). This case was collected through the foreign Surveillance Unit Acute Intussusception study occurring post Rotavirus vaccination. The subject was born at term. The subject''s birth weight is 3.39Kg. The subject had no history of intussusception. The subject had no previous significant illness/hospitalisations/operations. Feeding history: The subject currently fed formula. Until the age of 3 months the subject was exclusively breastfed. There was a change to the subject''s diet in the last week (change to formula). The subject had no feeding intolerance or food sensitivities. The subject received no current treatment. The subject received other vaccines as per schedule. Previous vaccination included ROTARIX (GlaxoSmithKline) given on 19 March 2008. On 13 May 2008, the subject received the 2nd dose of ROTARIX (unknown). On 17 May 2008, 4 days after vaccination with the 2nd dose of ROTARIX, the subject was admitted at hospital due to intussusception. The subject experienced passage of blood per rectum, vomiting and lethargy. No faeces sample was collected. The diagnosis of intussusception was made based on Enema (Site of intussusception: sigmoid colon). The subject was treated with guided fluoroscopy Enema. On 18 May 2008, the subject was discharged alive. At the time of reporting the outcome of the events was unspecified.


Changed on 9/14/2017

VAERS ID: 320744 Before After
VAERS Form:(blank) 1
Age:0.4
Gender:Female
Location:Foreign
Vaccinated:2008-05-13
Onset:2008-05-17
Submitted:2008-07-30
Entered:2008-07-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Lethargy, Rectal haemorrhage, Vomiting, Enema administration

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: Unknown
CDC 'Split Type': B0530264A

Write-up: This case was reported by a healthcare professional and described the occurrence of intussusception in a 4-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). This case was collected through the foreign Surveillance Unit Acute Intussusception study occurring post Rotavirus vaccination. The subject was born at term. The subject''s birth weight is 3.39Kg. The subject had no history of intussusception. The subject had no previous significant illness/hospitalisations/operations. Feeding history: The subject currently fed formula. Until the age of 3 months the subject was exclusively breastfed. There was a change to the subject''s diet in the last week (change to formula). The subject had no feeding intolerance or food sensitivities. The subject received no current treatment. The subject received other vaccines as per schedule. Previous vaccination included ROTARIX (GlaxoSmithKline) given on 19 March 2008. On 13 May 2008, the subject received the 2nd dose of ROTARIX (unknown). On 17 May 2008, 4 days after vaccination with the 2nd dose of ROTARIX, the subject was admitted at hospital due to intussusception. The subject experienced passage of blood per rectum, vomiting and lethargy. No faeces sample was collected. The diagnosis of intussusception was made based on Enema (Site of intussusception: sigmoid colon). The subject was treated with guided fluoroscopy Enema. On 18 May 2008, the subject was discharged alive. At the time of reporting the outcome of the events was unspecified.


Changed on 2/14/2018

VAERS ID: 320744 Before After
VAERS Form:1
Age:0.4
Gender:Female
Location:Foreign
Vaccinated:2008-05-13
Onset:2008-05-17
Submitted:2008-07-30
Entered:2008-07-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Lethargy, Rectal haemorrhage, Vomiting, Enema administration

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: Unknown
CDC 'Split Type': B0530264A

Write-up: This case was reported by a healthcare professional and described the occurrence of intussusception in a 4-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). This case was collected through the foreign Surveillance Unit Acute Intussusception study occurring post Rotavirus vaccination. The subject was born at term. The subject''s birth weight is 3.39Kg. The subject had no history of intussusception. The subject had no previous significant illness/hospitalisations/operations. Feeding history: The subject currently fed formula. Until the age of 3 months the subject was exclusively breastfed. There was a change to the subject''s diet in the last week (change to formula). The subject had no feeding intolerance or food sensitivities. The subject received no current treatment. The subject received other vaccines as per schedule. Previous vaccination included ROTARIX (GlaxoSmithKline) given on 19 March 2008. On 13 May 2008, the subject received the 2nd dose of ROTARIX (unknown). On 17 May 2008, 4 days after vaccination with the 2nd dose of ROTARIX, the subject was admitted at hospital due to intussusception. The subject experienced passage of blood per rectum, vomiting and lethargy. No faeces sample was collected. The diagnosis of intussusception was made based on Enema (Site of intussusception: sigmoid colon). The subject was treated with guided fluoroscopy Enema. On 18 May 2008, the subject was discharged alive. At the time of reporting the outcome of the events was unspecified.


Changed on 6/14/2018

VAERS ID: 320744 Before After
VAERS Form:1
Age:0.4
Gender:Female
Location:Foreign
Vaccinated:2008-05-13
Onset:2008-05-17
Submitted:2008-07-30
Entered:2008-07-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Lethargy, Rectal haemorrhage, Vomiting, Enema administration

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: Unknown
CDC 'Split Type': B0530264A

Write-up: This case was reported by a healthcare professional and described the occurrence of intussusception in a 4-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). This case was collected through the foreign Surveillance Unit Acute Intussusception study occurring post Rotavirus vaccination. The subject was born at term. The subject''s birth weight is 3.39Kg. The subject had no history of intussusception. The subject had no previous significant illness/hospitalisations/operations. Feeding history: The subject currently fed formula. Until the age of 3 months the subject was exclusively breastfed. There was a change to the subject''s diet in the last week (change to formula). The subject had no feeding intolerance or food sensitivities. The subject received no current treatment. The subject received other vaccines as per schedule. Previous vaccination included ROTARIX (GlaxoSmithKline) given on 19 March 2008. On 13 May 2008, the subject received the 2nd dose of ROTARIX (unknown). On 17 May 2008, 4 days after vaccination with the 2nd dose of ROTARIX, the subject was admitted at hospital due to intussusception. The subject experienced passage of blood per rectum, vomiting and lethargy. No faeces sample was collected. The diagnosis of intussusception was made based on Enema (Site of intussusception: sigmoid colon). The subject was treated with guided fluoroscopy Enema. On 18 May 2008, the subject was discharged alive. At the time of reporting the outcome of the events was unspecified.


Changed on 8/14/2018

VAERS ID: 320744 Before After
VAERS Form:1
Age:0.4
Gender:Female
Location:Foreign
Vaccinated:2008-05-13
Onset:2008-05-17
Submitted:2008-07-30
Entered:2008-07-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Lethargy, Rectal haemorrhage, Vomiting, Enema administration

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: Unknown
CDC 'Split Type': B0530264A

Write-up: This case was reported by a healthcare professional and described the occurrence of intussusception in a 4-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). This case was collected through the foreign Surveillance Unit Acute Intussusception study occurring post Rotavirus vaccination. The subject was born at term. The subject''s birth weight is 3.39Kg. The subject had no history of intussusception. The subject had no previous significant illness/hospitalisations/operations. Feeding history: The subject currently fed formula. Until the age of 3 months the subject was exclusively breastfed. There was a change to the subject''s diet in the last week (change to formula). The subject had no feeding intolerance or food sensitivities. The subject received no current treatment. The subject received other vaccines as per schedule. Previous vaccination included ROTARIX (GlaxoSmithKline) given on 19 March 2008. On 13 May 2008, the subject received the 2nd dose of ROTARIX (unknown). On 17 May 2008, 4 days after vaccination with the 2nd dose of ROTARIX, the subject was admitted at hospital due to intussusception. The subject experienced passage of blood per rectum, vomiting and lethargy. No faeces sample was collected. The diagnosis of intussusception was made based on Enema (Site of intussusception: sigmoid colon). The subject was treated with guided fluoroscopy Enema. On 18 May 2008, the subject was discharged alive. At the time of reporting the outcome of the events was unspecified.


Changed on 9/14/2018

VAERS ID: 320744 Before After
VAERS Form:1
Age:0.4
Gender:Female
Location:Foreign
Vaccinated:2008-05-13
Onset:2008-05-17
Submitted:2008-07-30
Entered:2008-07-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Lethargy, Rectal haemorrhage, Vomiting, Enema administration

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: Unknown
CDC 'Split Type': B0530264A

Write-up: This case was reported by a healthcare professional and described the occurrence of intussusception in a 4-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). This case was collected through the foreign Surveillance Unit Acute Intussusception study occurring post Rotavirus vaccination. The subject was born at term. The subject''s birth weight is 3.39Kg. The subject had no history of intussusception. The subject had no previous significant illness/hospitalisations/operations. Feeding history: The subject currently fed formula. Until the age of 3 months the subject was exclusively breastfed. There was a change to the subject''s diet in the last week (change to formula). The subject had no feeding intolerance or food sensitivities. The subject received no current treatment. The subject received other vaccines as per schedule. Previous vaccination included ROTARIX (GlaxoSmithKline) given on 19 March 2008. On 13 May 2008, the subject received the 2nd dose of ROTARIX (unknown). On 17 May 2008, 4 days after vaccination with the 2nd dose of ROTARIX, the subject was admitted at hospital due to intussusception. The subject experienced passage of blood per rectum, vomiting and lethargy. No faeces sample was collected. The diagnosis of intussusception was made based on Enema (Site of intussusception: sigmoid colon). The subject was treated with guided fluoroscopy Enema. On 18 May 2008, the subject was discharged alive. At the time of reporting the outcome of the events was unspecified.

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