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This is VAERS ID 322722

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 322722
VAERS Form:
Age:0.2
Gender:Male
Location:Foreign
Vaccinated:2008-07-01
Onset:2008-07-05
Submitted:2008-08-20
Entered:2008-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 0 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Barium enema, Body temperature increased, Dehydration, Haematochezia, Haemoglobin decreased, Intestinal perforation, Intussusception, Pallor, Pyrexia, Surgery, Ultrasound abdomen abnormal, Intestinal resection, Gastrointestinal sounds abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 8     Extended hospital stay? No
Previous Vaccinations:
Other Medications: thyroxine sodium
Current Illness: HEART MURMUR; HYPOTHYROIDISM
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Body temperature, 05Jul2008, 38.7Deg C; Hemoglobin, 05Jul2008, 9.9g/dl; Ultrasound abdomen, 05Jul2008, Obstructionunit
CDC 'Split Type': B0533379A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 2-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject had no allergy. Concurrent medical conditions included heart murmur and hypothyroidism. Concurrent medications included LEVOTYROXIN. On 1 July 2008, the subject received 1st dose of ROTARIX (oral), lot number not provided. On 5 July 2008, 4 days after vaccination with ROTARIX, the subject experienced bloody stools and fever (38.7 Deg C), leading to hospitalisation the same day. The physical examination showed dehydration, pallor, abdominal pain and absent bowel sounds. The laboratory test showed hemoglobin 9.9 g/dl. The abdominal ultrasound suggested an intestinal obstruction and the diagnosis of intussusception was made. Treatment with barium salt failed to resolve the intussusception. The surgery performed on 5 July 2008 revealed an ileocolic intussusception and 3 small bowel perforations which were repaired. A 20 cm ileocecal valvule resection was performed without complication. The subject was hospitalised for 8 days. On 12 July 2008, the subject was discharged from hospital in good clinical condition with a 3 days paracetamol treatment. At the time of reporting the events were resolved. The physician considered the events were almost certainly related to vaccination with ROTARIX.


Changed on 5/13/2013

VAERS ID: 322722 Before After
VAERS Form:
Age:0.2
Gender:Male
Location:Foreign
Vaccinated:2008-07-01
Onset:2008-07-05
Submitted:2008-08-20
Entered:2008-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 0 - / PO
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 0 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Barium enema, Body temperature increased, Dehydration, Haematochezia, Haemoglobin decreased, Intestinal perforation, Intussusception, Pallor, Pyrexia, Surgery, Ultrasound abdomen abnormal, Intestinal resection, Gastrointestinal sounds abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 8     Extended hospital stay? No
Previous Vaccinations:
Other Medications: thyroxine sodium
Current Illness: HEART MURMUR; HYPOTHYROIDISM
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Body temperature, 05Jul2008, 38.7Deg C; Hemoglobin, 05Jul2008, 9.9g/dl; Ultrasound abdomen, 05Jul2008, Obstructionunit
CDC 'Split Type': B0533379A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 2-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject had no allergy. Concurrent medical conditions included heart murmur and hypothyroidism. Concurrent medications included LEVOTYROXIN. On 1 July 2008, the subject received 1st dose of ROTARIX (oral), lot number not provided. On 5 July 2008, 4 days after vaccination with ROTARIX, the subject experienced bloody stools and fever (38.7 Deg C), leading to hospitalisation the same day. The physical examination showed dehydration, pallor, abdominal pain and absent bowel sounds. The laboratory test showed hemoglobin 9.9 g/dl. The abdominal ultrasound suggested an intestinal obstruction and the diagnosis of intussusception was made. Treatment with barium salt failed to resolve the intussusception. The surgery performed on 5 July 2008 revealed an ileocolic intussusception and 3 small bowel perforations which were repaired. A 20 cm ileocecal valvule resection was performed without complication. The subject was hospitalised for 8 days. On 12 July 2008, the subject was discharged from hospital in good clinical condition with a 3 days paracetamol treatment. At the time of reporting the events were resolved. The physician considered the events were almost certainly related to vaccination with ROTARIX.


Changed on 9/14/2017

VAERS ID: 322722 Before After
VAERS Form:(blank) 1
Age:0.2
Gender:Male
Location:Foreign
Vaccinated:2008-07-01
Onset:2008-07-05
Submitted:2008-08-20
Entered:2008-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 0 1 - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Barium enema, Body temperature increased, Dehydration, Haematochezia, Haemoglobin decreased, Intestinal perforation, Intussusception, Pallor, Pyrexia, Surgery, Ultrasound abdomen abnormal, Intestinal resection, Gastrointestinal sounds abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 8     Extended hospital stay? No
Previous Vaccinations:
Other Medications: thyroxine sodium
Current Illness: HEART MURMUR; HYPOTHYROIDISM
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Body temperature, 05Jul2008, 38.7Deg C; Hemoglobin, 05Jul2008, 9.9g/dl; Ultrasound abdomen, 05Jul2008, Obstructionunit
CDC 'Split Type': B0533379A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 2-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject had no allergy. Concurrent medical conditions included heart murmur and hypothyroidism. Concurrent medications included LEVOTYROXIN. On 1 July 2008, the subject received 1st dose of ROTARIX (oral), lot number not provided. On 5 July 2008, 4 days after vaccination with ROTARIX, the subject experienced bloody stools and fever (38.7 Deg C), leading to hospitalisation the same day. The physical examination showed dehydration, pallor, abdominal pain and absent bowel sounds. The laboratory test showed hemoglobin 9.9 g/dl. The abdominal ultrasound suggested an intestinal obstruction and the diagnosis of intussusception was made. Treatment with barium salt failed to resolve the intussusception. The surgery performed on 5 July 2008 revealed an ileocolic intussusception and 3 small bowel perforations which were repaired. A 20 cm ileocecal valvule resection was performed without complication. The subject was hospitalised for 8 days. On 12 July 2008, the subject was discharged from hospital in good clinical condition with a 3 days paracetamol treatment. At the time of reporting the events were resolved. The physician considered the events were almost certainly related to vaccination with ROTARIX.


Changed on 2/14/2018

VAERS ID: 322722 Before After
VAERS Form:1
Age:0.2
Gender:Male
Location:Foreign
Vaccinated:2008-07-01
Onset:2008-07-05
Submitted:2008-08-20
Entered:2008-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Barium enema, Body temperature increased, Dehydration, Haematochezia, Haemoglobin decreased, Intestinal perforation, Intussusception, Pallor, Pyrexia, Surgery, Ultrasound abdomen abnormal, Intestinal resection, Gastrointestinal sounds abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 8     Extended hospital stay? No
Previous Vaccinations:
Other Medications: thyroxine sodium
Current Illness: HEART MURMUR; HYPOTHYROIDISM
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Body temperature, 05Jul2008, 38.7Deg C; Hemoglobin, 05Jul2008, 9.9g/dl; Ultrasound abdomen, 05Jul2008, Obstructionunit
CDC 'Split Type': B0533379A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 2-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject had no allergy. Concurrent medical conditions included heart murmur and hypothyroidism. Concurrent medications included LEVOTYROXIN. On 1 July 2008, the subject received 1st dose of ROTARIX (oral), lot number not provided. On 5 July 2008, 4 days after vaccination with ROTARIX, the subject experienced bloody stools and fever (38.7 Deg C), leading to hospitalisation the same day. The physical examination showed dehydration, pallor, abdominal pain and absent bowel sounds. The laboratory test showed hemoglobin 9.9 g/dl. The abdominal ultrasound suggested an intestinal obstruction and the diagnosis of intussusception was made. Treatment with barium salt failed to resolve the intussusception. The surgery performed on 5 July 2008 revealed an ileocolic intussusception and 3 small bowel perforations which were repaired. A 20 cm ileocecal valvule resection was performed without complication. The subject was hospitalised for 8 days. On 12 July 2008, the subject was discharged from hospital in good clinical condition with a 3 days paracetamol treatment. At the time of reporting the events were resolved. The physician considered the events were almost certainly related to vaccination with ROTARIX.


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