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This is VAERS ID 322868

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 322868
VAERS Form:
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-03-04
Onset:2008-05-24
Submitted:2008-08-21
Entered:2008-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR - / 1 UN / UN
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 UN / UN
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Appendicectomy, Haematochezia, Intestinal obstruction, Intussusception, Mucous stools, Surgery, Vomiting, X-ray abnormal, Abdominal X-ray, Oral intake reduced

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, May2008, See Text
CDC 'Split Type': B0533717A

Write-up: This case was reported by a physician and described the occurrence of intussusception of intestine in a 7-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-IPV-Hib (manufacturer unspecified, intramuscular) given on 4 January 2008, 4 March 2008 and 5 May 2008; Hep B vaccine (manufacturer unspecified; intramuscular) given on 4 January 2008, 4 March 2008 and 5 May 2008; pneumococcal vaccine, ROTARIX (GlaxoSmithKline; oral) given on 4 January 2008; pneumococcal vaccine, unspecified (manufacturer unspecified; intramuscular) given on 4 January 2008; tuberculosis vaccine (manufacturer unspecified; intradermal) given on 30 October 2007. On 4 March 2008, the subject received the 2nd dose of ROTARIX (oral, lot number not provided). On 24 May 2008, 81 days after vaccination with the 2nd dose of ROTARIX, the subject was admitted into the emergency room due to 2 days of evolution with 6 times vomiting, gastric content, intolerance to PO and bloody stools (seemed like black currant jelly). Abdominal ultrasound and abdominal CT were not performed. Diagnosis was made by abdominal X-ray with the finding of air-fluid levels and data of intestinal obstruction and clinically. The physician considered the events were clinically significant (or requiring intervention). Surgery intervention was decided and was performed on 24 May 2008 with the finding ileococecal intussusception, which remitted by taxis (no resection); prophylactic appendectomy was performed without complications. Patient had good response after two days of evolution and was discharged on 26 May 2008. On 26 May 2008, the events were resolved. The physician considered the events were possibly related to vaccination with ROTARIX. Physician did not have more data to give a follow up report.


Changed on 5/13/2013

VAERS ID: 322868 Before After
VAERS Form:
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-03-04
Onset:2008-05-24
Submitted:2008-08-21
Entered:2008-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR - / 1 UN / UN
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 UN / UN
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 - / PO
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Appendicectomy, Haematochezia, Intestinal obstruction, Intussusception, Mucous stools, Surgery, Vomiting, X-ray abnormal, Abdominal X-ray, Oral intake reduced

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, May2008, See Text
CDC 'Split Type': B0533717A

Write-up: This case was reported by a physician and described the occurrence of intussusception of intestine in a 7-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-IPV-Hib (manufacturer unspecified, intramuscular) given on 4 January 2008, 4 March 2008 and 5 May 2008; Hep B vaccine (manufacturer unspecified; intramuscular) given on 4 January 2008, 4 March 2008 and 5 May 2008; pneumococcal vaccine, ROTARIX (GlaxoSmithKline; oral) given on 4 January 2008; pneumococcal vaccine, unspecified (manufacturer unspecified; intramuscular) given on 4 January 2008; tuberculosis vaccine (manufacturer unspecified; intradermal) given on 30 October 2007. On 4 March 2008, the subject received the 2nd dose of ROTARIX (oral, lot number not provided). On 24 May 2008, 81 days after vaccination with the 2nd dose of ROTARIX, the subject was admitted into the emergency room due to 2 days of evolution with 6 times vomiting, gastric content, intolerance to PO and bloody stools (seemed like black currant jelly). Abdominal ultrasound and abdominal CT were not performed. Diagnosis was made by abdominal X-ray with the finding of air-fluid levels and data of intestinal obstruction and clinically. The physician considered the events were clinically significant (or requiring intervention). Surgery intervention was decided and was performed on 24 May 2008 with the finding ileococecal intussusception, which remitted by taxis (no resection); prophylactic appendectomy was performed without complications. Patient had good response after two days of evolution and was discharged on 26 May 2008. On 26 May 2008, the events were resolved. The physician considered the events were possibly related to vaccination with ROTARIX. Physician did not have more data to give a follow up report.


Changed on 9/14/2017

VAERS ID: 322868 Before After
VAERS Form:(blank) 1
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-03-04
Onset:2008-05-24
Submitted:2008-08-21
Entered:2008-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR - / 1 2 UN / UN
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 2 UN / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 2 - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Appendicectomy, Haematochezia, Intestinal obstruction, Intussusception, Mucous stools, Surgery, Vomiting, X-ray abnormal, Abdominal X-ray, Oral intake reduced

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, May2008, See Text
CDC 'Split Type': B0533717A

Write-up: This case was reported by a physician and described the occurrence of intussusception of intestine in a 7-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-IPV-Hib (manufacturer unspecified, intramuscular) given on 4 January 2008, 4 March 2008 and 5 May 2008; Hep B vaccine (manufacturer unspecified; intramuscular) given on 4 January 2008, 4 March 2008 and 5 May 2008; pneumococcal vaccine, ROTARIX (GlaxoSmithKline; oral) given on 4 January 2008; pneumococcal vaccine, unspecified (manufacturer unspecified; intramuscular) given on 4 January 2008; tuberculosis vaccine (manufacturer unspecified; intradermal) given on 30 October 2007. On 4 March 2008, the subject received the 2nd dose of ROTARIX (oral, lot number not provided). On 24 May 2008, 81 days after vaccination with the 2nd dose of ROTARIX, the subject was admitted into the emergency room due to 2 days of evolution with 6 times vomiting, gastric content, intolerance to PO and bloody stools (seemed like black currant jelly). Abdominal ultrasound and abdominal CT were not performed. Diagnosis was made by abdominal X-ray with the finding of air-fluid levels and data of intestinal obstruction and clinically. The physician considered the events were clinically significant (or requiring intervention). Surgery intervention was decided and was performed on 24 May 2008 with the finding ileococecal intussusception, which remitted by taxis (no resection); prophylactic appendectomy was performed without complications. Patient had good response after two days of evolution and was discharged on 26 May 2008. On 26 May 2008, the events were resolved. The physician considered the events were possibly related to vaccination with ROTARIX. Physician did not have more data to give a follow up report.


Changed on 2/14/2018

VAERS ID: 322868 Before After
VAERS Form:1
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-03-04
Onset:2008-05-24
Submitted:2008-08-21
Entered:2008-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR - / 2 UN / UN
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 UN / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 2 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Appendicectomy, Haematochezia, Intestinal obstruction, Intussusception, Mucous stools, Surgery, Vomiting, X-ray abnormal, Abdominal X-ray, Oral intake reduced

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, May2008, See Text
CDC 'Split Type': B0533717A

Write-up: This case was reported by a physician and described the occurrence of intussusception of intestine in a 7-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-IPV-Hib (manufacturer unspecified, intramuscular) given on 4 January 2008, 4 March 2008 and 5 May 2008; Hep B vaccine (manufacturer unspecified; intramuscular) given on 4 January 2008, 4 March 2008 and 5 May 2008; pneumococcal vaccine, ROTARIX (GlaxoSmithKline; oral) given on 4 January 2008; pneumococcal vaccine, unspecified (manufacturer unspecified; intramuscular) given on 4 January 2008; tuberculosis vaccine (manufacturer unspecified; intradermal) given on 30 October 2007. On 4 March 2008, the subject received the 2nd dose of ROTARIX (oral, lot number not provided). On 24 May 2008, 81 days after vaccination with the 2nd dose of ROTARIX, the subject was admitted into the emergency room due to 2 days of evolution with 6 times vomiting, gastric content, intolerance to PO and bloody stools (seemed like black currant jelly). Abdominal ultrasound and abdominal CT were not performed. Diagnosis was made by abdominal X-ray with the finding of air-fluid levels and data of intestinal obstruction and clinically. The physician considered the events were clinically significant (or requiring intervention). Surgery intervention was decided and was performed on 24 May 2008 with the finding ileococecal intussusception, which remitted by taxis (no resection); prophylactic appendectomy was performed without complications. Patient had good response after two days of evolution and was discharged on 26 May 2008. On 26 May 2008, the events were resolved. The physician considered the events were possibly related to vaccination with ROTARIX. Physician did not have more data to give a follow up report.


Changed on 6/14/2018

VAERS ID: 322868 Before After
VAERS Form:1
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-03-04
Onset:2008-05-24
Submitted:2008-08-21
Entered:2008-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR - / 2 UN / UN
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 UN / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 2 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Appendicectomy, Haematochezia, Intestinal obstruction, Intussusception, Mucous stools, Surgery, Vomiting, X-ray abnormal, Abdominal X-ray, Oral intake reduced

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, May2008, See Text
CDC 'Split Type': B0533717A

Write-up: This case was reported by a physician and described the occurrence of intussusception of intestine in a 7-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-IPV-Hib (manufacturer unspecified, intramuscular) given on 4 January 2008, 4 March 2008 and 5 May 2008; Hep B vaccine (manufacturer unspecified; intramuscular) given on 4 January 2008, 4 March 2008 and 5 May 2008; pneumococcal vaccine, ROTARIX (GlaxoSmithKline; oral) given on 4 January 2008; pneumococcal vaccine, unspecified (manufacturer unspecified; intramuscular) given on 4 January 2008; tuberculosis vaccine (manufacturer unspecified; intradermal) given on 30 October 2007. On 4 March 2008, the subject received the 2nd dose of ROTARIX (oral, lot number not provided). On 24 May 2008, 81 days after vaccination with the 2nd dose of ROTARIX, the subject was admitted into the emergency room due to 2 days of evolution with 6 times vomiting, gastric content, intolerance to PO and bloody stools (seemed like black currant jelly). Abdominal ultrasound and abdominal CT were not performed. Diagnosis was made by abdominal X-ray with the finding of air-fluid levels and data of intestinal obstruction and clinically. The physician considered the events were clinically significant (or requiring intervention). Surgery intervention was decided and was performed on 24 May 2008 with the finding ileococecal intussusception, which remitted by taxis (no resection); prophylactic appendectomy was performed without complications. Patient had good response after two days of evolution and was discharged on 26 May 2008. On 26 May 2008, the events were resolved. The physician considered the events were possibly related to vaccination with ROTARIX. Physician did not have more data to give a follow up report.


Changed on 8/14/2018

VAERS ID: 322868 Before After
VAERS Form:1
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-03-04
Onset:2008-05-24
Submitted:2008-08-21
Entered:2008-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR - / 2 UN / UN
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 UN / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 2 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Appendicectomy, Haematochezia, Intestinal obstruction, Intussusception, Mucous stools, Surgery, Vomiting, X-ray abnormal, Abdominal X-ray, Oral intake reduced

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, May2008, See Text
CDC 'Split Type': B0533717A

Write-up: This case was reported by a physician and described the occurrence of intussusception of intestine in a 7-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-IPV-Hib (manufacturer unspecified, intramuscular) given on 4 January 2008, 4 March 2008 and 5 May 2008; Hep B vaccine (manufacturer unspecified; intramuscular) given on 4 January 2008, 4 March 2008 and 5 May 2008; pneumococcal vaccine, ROTARIX (GlaxoSmithKline; oral) given on 4 January 2008; pneumococcal vaccine, unspecified (manufacturer unspecified; intramuscular) given on 4 January 2008; tuberculosis vaccine (manufacturer unspecified; intradermal) given on 30 October 2007. On 4 March 2008, the subject received the 2nd dose of ROTARIX (oral, lot number not provided). On 24 May 2008, 81 days after vaccination with the 2nd dose of ROTARIX, the subject was admitted into the emergency room due to 2 days of evolution with 6 times vomiting, gastric content, intolerance to PO and bloody stools (seemed like black currant jelly). Abdominal ultrasound and abdominal CT were not performed. Diagnosis was made by abdominal X-ray with the finding of air-fluid levels and data of intestinal obstruction and clinically. The physician considered the events were clinically significant (or requiring intervention). Surgery intervention was decided and was performed on 24 May 2008 with the finding ileococecal intussusception, which remitted by taxis (no resection); prophylactic appendectomy was performed without complications. Patient had good response after two days of evolution and was discharged on 26 May 2008. On 26 May 2008, the events were resolved. The physician considered the events were possibly related to vaccination with ROTARIX. Physician did not have more data to give a follow up report.

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