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This is VAERS ID 322227

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 322227
VAERS Form:
Age:0.2
Gender:Male
Location:Foreign
Vaccinated:2007-11-18
Onset:2008-03-03
Submitted:2008-08-14
Entered:2008-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / IM
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / IM
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 0 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Inappropriate schedule of drug administration, Intussusception, Surgery, Vomiting, X-ray abnormal, Ultrasound abdomen abnormal, Abdominal X-ray

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? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, Mar2008, See text; Ultrasound abdomen, Mar2008, see text
CDC 'Split Type': B0533050A

Write-up: This case was reported by a physician and described the occurrence of intestinal intussusception in a 5-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject had no history or family history of intussusception or bowel abnormalities. He had no congenital intestinal malformation or other gastrointestinal malformation and dysfunction. Previous and/or concurrent vaccination included DTaP, inactivated poliomyelitis and HIB vaccine (manufacturer unspecified; intramuscular) given on 18 November 2007 and 3 January 2008; hepatitis B recombinant (manufacturer unspecified; intramuscular) given on 12 September 2007; pneumococcal vaccine, unspecified (manufacturer unspecified; intramuscular) given on 18 November 2007 and 3 January 2008; tuberculosis vaccine (manufacturer unspecified; intradermal) given on 12 September 2007. On 18 November 2007, the subject received the 1st dose of ROTARIX (oral, lot number not provided). On 3 March 2008, 106 days after vaccination with the 1st dose of ROTARIX, the subject was admitted in the emergency room with abdominal pain, a colic type, 6 times vomiting with gastric content and two evacuations without mucus nor blood, with the initial diagnosis of intestinal intussusception. Abdominal ultrasound was performed with finding of loops distention; Abdominal X-Ray showed air-fluid levels. The subject had it clinically too. The physician considered the events were clinically significant (or requiring intervention). On 06 March 2008, surgical intervention was decided and was performed with the finding of intussusception without referring the type, which remitted by taxis without the need of intestinal resection, no complications. Patient had good response and favorable evolution and was discharged on 07 March 2008. On 7 March 2008, the events were resolved. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 5/13/2013

VAERS ID: 322227 Before After
VAERS Form:
Age:0.2
Gender:Male
Location:Foreign
Vaccinated:2007-11-18
Onset:2008-03-03
Submitted:2008-08-14
Entered:2008-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / IM
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / IM
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 0 - / PO
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 0 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Inappropriate schedule of drug administration, Intussusception, Surgery, Vomiting, X-ray abnormal, Ultrasound abdomen abnormal, Abdominal X-ray

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? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, Mar2008, See text; Ultrasound abdomen, Mar2008, see text
CDC 'Split Type': B0533050A

Write-up: This case was reported by a physician and described the occurrence of intestinal intussusception in a 5-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject had no history or family history of intussusception or bowel abnormalities. He had no congenital intestinal malformation or other gastrointestinal malformation and dysfunction. Previous and/or concurrent vaccination included DTaP, inactivated poliomyelitis and HIB vaccine (manufacturer unspecified; intramuscular) given on 18 November 2007 and 3 January 2008; hepatitis B recombinant (manufacturer unspecified; intramuscular) given on 12 September 2007; pneumococcal vaccine, unspecified (manufacturer unspecified; intramuscular) given on 18 November 2007 and 3 January 2008; tuberculosis vaccine (manufacturer unspecified; intradermal) given on 12 September 2007. On 18 November 2007, the subject received the 1st dose of ROTARIX (oral, lot number not provided). On 3 March 2008, 106 days after vaccination with the 1st dose of ROTARIX, the subject was admitted in the emergency room with abdominal pain, a colic type, 6 times vomiting with gastric content and two evacuations without mucus nor blood, with the initial diagnosis of intestinal intussusception. Abdominal ultrasound was performed with finding of loops distention; Abdominal X-Ray showed air-fluid levels. The subject had it clinically too. The physician considered the events were clinically significant (or requiring intervention). On 06 March 2008, surgical intervention was decided and was performed with the finding of intussusception without referring the type, which remitted by taxis without the need of intestinal resection, no complications. Patient had good response and favorable evolution and was discharged on 07 March 2008. On 7 March 2008, the events were resolved. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 9/14/2017

VAERS ID: 322227 Before After
VAERS Form:(blank) 1
Age:0.2
Gender:Male
Location:Foreign
Vaccinated:2007-11-18
Onset:2008-03-03
Submitted:2008-08-14
Entered:2008-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK UN / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK UN / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK UN / IM
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK UN / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 0 1 - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Inappropriate schedule of drug administration, Intussusception, Surgery, Vomiting, X-ray abnormal, Ultrasound abdomen abnormal, Abdominal X-ray

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? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, Mar2008, See text; Ultrasound abdomen, Mar2008, see text
CDC 'Split Type': B0533050A

Write-up: This case was reported by a physician and described the occurrence of intestinal intussusception in a 5-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject had no history or family history of intussusception or bowel abnormalities. He had no congenital intestinal malformation or other gastrointestinal malformation and dysfunction. Previous and/or concurrent vaccination included DTaP, inactivated poliomyelitis and HIB vaccine (manufacturer unspecified; intramuscular) given on 18 November 2007 and 3 January 2008; hepatitis B recombinant (manufacturer unspecified; intramuscular) given on 12 September 2007; pneumococcal vaccine, unspecified (manufacturer unspecified; intramuscular) given on 18 November 2007 and 3 January 2008; tuberculosis vaccine (manufacturer unspecified; intradermal) given on 12 September 2007. On 18 November 2007, the subject received the 1st dose of ROTARIX (oral, lot number not provided). On 3 March 2008, 106 days after vaccination with the 1st dose of ROTARIX, the subject was admitted in the emergency room with abdominal pain, a colic type, 6 times vomiting with gastric content and two evacuations without mucus nor blood, with the initial diagnosis of intestinal intussusception. Abdominal ultrasound was performed with finding of loops distention; Abdominal X-Ray showed air-fluid levels. The subject had it clinically too. The physician considered the events were clinically significant (or requiring intervention). On 06 March 2008, surgical intervention was decided and was performed with the finding of intussusception without referring the type, which remitted by taxis without the need of intestinal resection, no complications. Patient had good response and favorable evolution and was discharged on 07 March 2008. On 7 March 2008, the events were resolved. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 2/14/2018

VAERS ID: 322227 Before After
VAERS Form:1
Age:0.2
Gender:Male
Location:Foreign
Vaccinated:2007-11-18
Onset:2008-03-03
Submitted:2008-08-14
Entered:2008-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Inappropriate schedule of drug administration, Intussusception, Surgery, Vomiting, X-ray abnormal, Ultrasound abdomen abnormal, Abdominal X-ray

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? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, Mar2008, See text; Ultrasound abdomen, Mar2008, see text
CDC 'Split Type': B0533050A

Write-up: This case was reported by a physician and described the occurrence of intestinal intussusception in a 5-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject had no history or family history of intussusception or bowel abnormalities. He had no congenital intestinal malformation or other gastrointestinal malformation and dysfunction. Previous and/or concurrent vaccination included DTaP, inactivated poliomyelitis and HIB vaccine (manufacturer unspecified; intramuscular) given on 18 November 2007 and 3 January 2008; hepatitis B recombinant (manufacturer unspecified; intramuscular) given on 12 September 2007; pneumococcal vaccine, unspecified (manufacturer unspecified; intramuscular) given on 18 November 2007 and 3 January 2008; tuberculosis vaccine (manufacturer unspecified; intradermal) given on 12 September 2007. On 18 November 2007, the subject received the 1st dose of ROTARIX (oral, lot number not provided). On 3 March 2008, 106 days after vaccination with the 1st dose of ROTARIX, the subject was admitted in the emergency room with abdominal pain, a colic type, 6 times vomiting with gastric content and two evacuations without mucus nor blood, with the initial diagnosis of intestinal intussusception. Abdominal ultrasound was performed with finding of loops distention; Abdominal X-Ray showed air-fluid levels. The subject had it clinically too. The physician considered the events were clinically significant (or requiring intervention). On 06 March 2008, surgical intervention was decided and was performed with the finding of intussusception without referring the type, which remitted by taxis without the need of intestinal resection, no complications. Patient had good response and favorable evolution and was discharged on 07 March 2008. On 7 March 2008, the events were resolved. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 6/14/2018

VAERS ID: 322227 Before After
VAERS Form:1
Age:0.2
Gender:Male
Location:Foreign
Vaccinated:2007-11-18
Onset:2008-03-03
Submitted:2008-08-14
Entered:2008-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Inappropriate schedule of drug administration, Intussusception, Surgery, Vomiting, X-ray abnormal, Ultrasound abdomen abnormal, Abdominal X-ray

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? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, Mar2008, See text; Ultrasound abdomen, Mar2008, see text
CDC 'Split Type': B0533050A

Write-up: This case was reported by a physician and described the occurrence of intestinal intussusception in a 5-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject had no history or family history of intussusception or bowel abnormalities. He had no congenital intestinal malformation or other gastrointestinal malformation and dysfunction. Previous and/or concurrent vaccination included DTaP, inactivated poliomyelitis and HIB vaccine (manufacturer unspecified; intramuscular) given on 18 November 2007 and 3 January 2008; hepatitis B recombinant (manufacturer unspecified; intramuscular) given on 12 September 2007; pneumococcal vaccine, unspecified (manufacturer unspecified; intramuscular) given on 18 November 2007 and 3 January 2008; tuberculosis vaccine (manufacturer unspecified; intradermal) given on 12 September 2007. On 18 November 2007, the subject received the 1st dose of ROTARIX (oral, lot number not provided). On 3 March 2008, 106 days after vaccination with the 1st dose of ROTARIX, the subject was admitted in the emergency room with abdominal pain, a colic type, 6 times vomiting with gastric content and two evacuations without mucus nor blood, with the initial diagnosis of intestinal intussusception. Abdominal ultrasound was performed with finding of loops distention; Abdominal X-Ray showed air-fluid levels. The subject had it clinically too. The physician considered the events were clinically significant (or requiring intervention). On 06 March 2008, surgical intervention was decided and was performed with the finding of intussusception without referring the type, which remitted by taxis without the need of intestinal resection, no complications. Patient had good response and favorable evolution and was discharged on 07 March 2008. On 7 March 2008, the events were resolved. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 8/14/2018

VAERS ID: 322227 Before After
VAERS Form:1
Age:0.2
Gender:Male
Location:Foreign
Vaccinated:2007-11-18
Onset:2008-03-03
Submitted:2008-08-14
Entered:2008-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Inappropriate schedule of drug administration, Intussusception, Surgery, Vomiting, X-ray abnormal, Ultrasound abdomen abnormal, Abdominal X-ray

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? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, Mar2008, See text; Ultrasound abdomen, Mar2008, see text
CDC 'Split Type': B0533050A

Write-up: This case was reported by a physician and described the occurrence of intestinal intussusception in a 5-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject had no history or family history of intussusception or bowel abnormalities. He had no congenital intestinal malformation or other gastrointestinal malformation and dysfunction. Previous and/or concurrent vaccination included DTaP, inactivated poliomyelitis and HIB vaccine (manufacturer unspecified; intramuscular) given on 18 November 2007 and 3 January 2008; hepatitis B recombinant (manufacturer unspecified; intramuscular) given on 12 September 2007; pneumococcal vaccine, unspecified (manufacturer unspecified; intramuscular) given on 18 November 2007 and 3 January 2008; tuberculosis vaccine (manufacturer unspecified; intradermal) given on 12 September 2007. On 18 November 2007, the subject received the 1st dose of ROTARIX (oral, lot number not provided). On 3 March 2008, 106 days after vaccination with the 1st dose of ROTARIX, the subject was admitted in the emergency room with abdominal pain, a colic type, 6 times vomiting with gastric content and two evacuations without mucus nor blood, with the initial diagnosis of intestinal intussusception. Abdominal ultrasound was performed with finding of loops distention; Abdominal X-Ray showed air-fluid levels. The subject had it clinically too. The physician considered the events were clinically significant (or requiring intervention). On 06 March 2008, surgical intervention was decided and was performed with the finding of intussusception without referring the type, which remitted by taxis without the need of intestinal resection, no complications. Patient had good response and favorable evolution and was discharged on 07 March 2008. On 7 March 2008, the events were resolved. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 9/14/2018

VAERS ID: 322227 Before After
VAERS Form:1
Age:0.2
Gender:Male
Location:Foreign
Vaccinated:2007-11-18
Onset:2008-03-03
Submitted:2008-08-14
Entered:2008-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Inappropriate schedule of drug administration, Intussusception, Surgery, Vomiting, X-ray abnormal, Ultrasound abdomen abnormal, Abdominal X-ray

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? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, Mar2008, See text; Ultrasound abdomen, Mar2008, see text
CDC 'Split Type': B0533050A

Write-up: This case was reported by a physician and described the occurrence of intestinal intussusception in a 5-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject had no history or family history of intussusception or bowel abnormalities. He had no congenital intestinal malformation or other gastrointestinal malformation and dysfunction. Previous and/or concurrent vaccination included DTaP, inactivated poliomyelitis and HIB vaccine (manufacturer unspecified; intramuscular) given on 18 November 2007 and 3 January 2008; hepatitis B recombinant (manufacturer unspecified; intramuscular) given on 12 September 2007; pneumococcal vaccine, unspecified (manufacturer unspecified; intramuscular) given on 18 November 2007 and 3 January 2008; tuberculosis vaccine (manufacturer unspecified; intradermal) given on 12 September 2007. On 18 November 2007, the subject received the 1st dose of ROTARIX (oral, lot number not provided). On 3 March 2008, 106 days after vaccination with the 1st dose of ROTARIX, the subject was admitted in the emergency room with abdominal pain, a colic type, 6 times vomiting with gastric content and two evacuations without mucus nor blood, with the initial diagnosis of intestinal intussusception. Abdominal ultrasound was performed with finding of loops distention; Abdominal X-Ray showed air-fluid levels. The subject had it clinically too. The physician considered the events were clinically significant (or requiring intervention). On 06 March 2008, surgical intervention was decided and was performed with the finding of intussusception without referring the type, which remitted by taxis without the need of intestinal resection, no complications. Patient had good response and favorable evolution and was discharged on 07 March 2008. On 7 March 2008, the events were resolved. The physician considered the events were possibly related to vaccination with ROTARIX.

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