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This is VAERS ID 322636

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 322636
VAERS Form:
Age:0.3
Gender:Female
Location:Foreign
Vaccinated:2008-07-14
Onset:2008-07-17
Submitted:2008-08-19
Entered:2008-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - - / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Surgery, Enema administration, Colectomy, Intestinal operation

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
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: UNK
CDC 'Split Type': D0058386A

Write-up: This case was reported by an unknown physician via a regulatory authority and described the occurrence of invagination of intestine in a 3-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). It was unknown whether or not the subject experienced any adverse event post previous vaccination(s). On 14 July 2008 the subject received an unspecified dose of ROTARIX (0.5 ml, oral). Approximately three days post vaccination with ROTARIX, on 17 July 2008, the subject experienced invagination of intestine. The subject was hospitalised for an unknown period of time. The reporting physician considered that the event was life threatening. Treatment included hydrostatic disinvagination on 17 July 2008 without success. On 18 July 2008 the subject underwent bowel surgery. The reporting physician considered undesirable vaccination adverse reaction. At the time of reporting, on 08 August 2008, the events were resolved with the following sequelae (state post surgery). No further information will be available.


Changed on 5/13/2013

VAERS ID: 322636 Before After
VAERS Form:
Age:0.3
Gender:Female
Location:Foreign
Vaccinated:2008-07-14
Onset:2008-07-17
Submitted:2008-08-19
Entered:2008-08-19
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: Intussusception, Surgery, Enema administration, Colectomy, Intestinal operation

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
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: UNK
CDC 'Split Type': D0058386A

Write-up: This case was reported by an unknown physician via a regulatory authority and described the occurrence of invagination of intestine in a 3-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). It was unknown whether or not the subject experienced any adverse event post previous vaccination(s). On 14 July 2008 the subject received an unspecified dose of ROTARIX (0.5 ml, oral). Approximately three days post vaccination with ROTARIX, on 17 July 2008, the subject experienced invagination of intestine. The subject was hospitalised for an unknown period of time. The reporting physician considered that the event was life threatening. Treatment included hydrostatic disinvagination on 17 July 2008 without success. On 18 July 2008 the subject underwent bowel surgery. The reporting physician considered undesirable vaccination adverse reaction. At the time of reporting, on 08 August 2008, the events were resolved with the following sequelae (state post surgery). No further information will be available.


Changed on 9/14/2017

VAERS ID: 322636 Before After
VAERS Form:(blank) 1
Age:0.3
Gender:Female
Location:Foreign
Vaccinated:2008-07-14
Onset:2008-07-17
Submitted:2008-08-19
Entered:2008-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - UNK - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Surgery, Enema administration, Colectomy, Intestinal operation

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
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: UNK
CDC 'Split Type': D0058386A

Write-up: This case was reported by an unknown physician via a regulatory authority and described the occurrence of invagination of intestine in a 3-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). It was unknown whether or not the subject experienced any adverse event post previous vaccination(s). On 14 July 2008 the subject received an unspecified dose of ROTARIX (0.5 ml, oral). Approximately three days post vaccination with ROTARIX, on 17 July 2008, the subject experienced invagination of intestine. The subject was hospitalised for an unknown period of time. The reporting physician considered that the event was life threatening. Treatment included hydrostatic disinvagination on 17 July 2008 without success. On 18 July 2008 the subject underwent bowel surgery. The reporting physician considered undesirable vaccination adverse reaction. At the time of reporting, on 08 August 2008, the events were resolved with the following sequelae (state post surgery). No further information will be available.


Changed on 2/14/2018

VAERS ID: 322636 Before After
VAERS Form:1
Age:0.3
Gender:Female
Location:Foreign
Vaccinated:2008-07-14
Onset:2008-07-17
Submitted:2008-08-19
Entered:2008-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Surgery, Enema administration, Colectomy, Intestinal operation

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
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: UNK
CDC 'Split Type': D0058386A

Write-up: This case was reported by an unknown physician via a regulatory authority and described the occurrence of invagination of intestine in a 3-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). It was unknown whether or not the subject experienced any adverse event post previous vaccination(s). On 14 July 2008 the subject received an unspecified dose of ROTARIX (0.5 ml, oral). Approximately three days post vaccination with ROTARIX, on 17 July 2008, the subject experienced invagination of intestine. The subject was hospitalised for an unknown period of time. The reporting physician considered that the event was life threatening. Treatment included hydrostatic disinvagination on 17 July 2008 without success. On 18 July 2008 the subject underwent bowel surgery. The reporting physician considered undesirable vaccination adverse reaction. At the time of reporting, on 08 August 2008, the events were resolved with the following sequelae (state post surgery). No further information will be available.


Changed on 6/14/2018

VAERS ID: 322636 Before After
VAERS Form:1
Age:0.3
Gender:Female
Location:Foreign
Vaccinated:2008-07-14
Onset:2008-07-17
Submitted:2008-08-19
Entered:2008-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Surgery, Enema administration, Colectomy, Intestinal operation

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
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: UNK
CDC 'Split Type': D0058386A

Write-up: This case was reported by an unknown physician via a regulatory authority and described the occurrence of invagination of intestine in a 3-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). It was unknown whether or not the subject experienced any adverse event post previous vaccination(s). On 14 July 2008 the subject received an unspecified dose of ROTARIX (0.5 ml, oral). Approximately three days post vaccination with ROTARIX, on 17 July 2008, the subject experienced invagination of intestine. The subject was hospitalised for an unknown period of time. The reporting physician considered that the event was life threatening. Treatment included hydrostatic disinvagination on 17 July 2008 without success. On 18 July 2008 the subject underwent bowel surgery. The reporting physician considered undesirable vaccination adverse reaction. At the time of reporting, on 08 August 2008, the events were resolved with the following sequelae (state post surgery). No further information will be available.


Changed on 8/14/2018

VAERS ID: 322636 Before After
VAERS Form:1
Age:0.3
Gender:Female
Location:Foreign
Vaccinated:2008-07-14
Onset:2008-07-17
Submitted:2008-08-19
Entered:2008-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Surgery, Enema administration, Colectomy, Intestinal operation

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
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: UNK
CDC 'Split Type': D0058386A

Write-up: This case was reported by an unknown physician via a regulatory authority and described the occurrence of invagination of intestine in a 3-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). It was unknown whether or not the subject experienced any adverse event post previous vaccination(s). On 14 July 2008 the subject received an unspecified dose of ROTARIX (0.5 ml, oral). Approximately three days post vaccination with ROTARIX, on 17 July 2008, the subject experienced invagination of intestine. The subject was hospitalised for an unknown period of time. The reporting physician considered that the event was life threatening. Treatment included hydrostatic disinvagination on 17 July 2008 without success. On 18 July 2008 the subject underwent bowel surgery. The reporting physician considered undesirable vaccination adverse reaction. At the time of reporting, on 08 August 2008, the events were resolved with the following sequelae (state post surgery). No further information will be available.


Changed on 9/14/2018

VAERS ID: 322636 Before After
VAERS Form:1
Age:0.3
Gender:Female
Location:Foreign
Vaccinated:2008-07-14
Onset:2008-07-17
Submitted:2008-08-19
Entered:2008-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Surgery, Enema administration, Colectomy, Intestinal operation

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
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: UNK
CDC 'Split Type': D0058386A

Write-up: This case was reported by an unknown physician via a regulatory authority and described the occurrence of invagination of intestine in a 3-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). It was unknown whether or not the subject experienced any adverse event post previous vaccination(s). On 14 July 2008 the subject received an unspecified dose of ROTARIX (0.5 ml, oral). Approximately three days post vaccination with ROTARIX, on 17 July 2008, the subject experienced invagination of intestine. The subject was hospitalised for an unknown period of time. The reporting physician considered that the event was life threatening. Treatment included hydrostatic disinvagination on 17 July 2008 without success. On 18 July 2008 the subject underwent bowel surgery. The reporting physician considered undesirable vaccination adverse reaction. At the time of reporting, on 08 August 2008, the events were resolved with the following sequelae (state post surgery). No further information will be available.


Changed on 10/14/2018

VAERS ID: 322636 Before After
VAERS Form:1
Age:0.3
Gender:Female
Location:Foreign
Vaccinated:2008-07-14
Onset:2008-07-17
Submitted:2008-08-19
Entered:2008-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Surgery, Enema administration, Colectomy, Intestinal operation

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
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: UNK
CDC 'Split Type': D0058386A

Write-up: This case was reported by an unknown physician via a regulatory authority and described the occurrence of invagination of intestine in a 3-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). It was unknown whether or not the subject experienced any adverse event post previous vaccination(s). On 14 July 2008 the subject received an unspecified dose of ROTARIX (0.5 ml, oral). Approximately three days post vaccination with ROTARIX, on 17 July 2008, the subject experienced invagination of intestine. The subject was hospitalised for an unknown period of time. The reporting physician considered that the event was life threatening. Treatment included hydrostatic disinvagination on 17 July 2008 without success. On 18 July 2008 the subject underwent bowel surgery. The reporting physician considered undesirable vaccination adverse reaction. At the time of reporting, on 08 August 2008, the events were resolved with the following sequelae (state post surgery). No further information will be available.

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