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This is VAERS ID 326448

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 326448
VAERS Form:
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-09-13
Onset:2008-09-18
Submitted:2008-09-29
Entered:2008-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 0 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Crying, Haematochezia, Intussusception, Mucous stools, Surgery, Vomiting, Ultrasound scan abnormal

Life Threatening? Yes
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: Ultrasound scan, 18Sep2008, ISunit
CDC 'Split Type': B0538669A

Write-up: This case was reported by a physician and described the occurrence of ileocolic intussusception in a 3-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). On 13 September 2008 the subject received 1st dose of ROTARIX (unknown) lot number not provided. On 18 September 2008, 5 days after vaccination with ROTARIX, the subject presented severe vomiting enough to be hospitalized. The subject cried excessively and passed jelly currant stools. Relevant test included ultrasonography which showed ileocolic intussusception. The following day in the morning the subject underwent a surgery. The subject was hospitalised and the physician considered the events were life threatening and clinically significant (or requiring intervention). At the time of reporting the events were unresolved. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 5/13/2013

VAERS ID: 326448 Before After
VAERS Form:
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-09-13
Onset:2008-09-18
Submitted:2008-09-29
Entered:2008-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 0 UN / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 0 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Crying, Haematochezia, Intussusception, Mucous stools, Surgery, Vomiting, Ultrasound scan abnormal

Life Threatening? Yes
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: Ultrasound scan, 18Sep2008, ISunit
CDC 'Split Type': B0538669A

Write-up: This case was reported by a physician and described the occurrence of ileocolic intussusception in a 3-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). On 13 September 2008 the subject received 1st dose of ROTARIX (unknown) lot number not provided. On 18 September 2008, 5 days after vaccination with ROTARIX, the subject presented severe vomiting enough to be hospitalized. The subject cried excessively and passed jelly currant stools. Relevant test included ultrasonography which showed ileocolic intussusception. The following day in the morning the subject underwent a surgery. The subject was hospitalised and the physician considered the events were life threatening and clinically significant (or requiring intervention). At the time of reporting the events were unresolved. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 9/14/2017

VAERS ID: 326448 Before After
VAERS Form:(blank) 1
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-09-13
Onset:2008-09-18
Submitted:2008-09-29
Entered:2008-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 0 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Crying, Haematochezia, Intussusception, Mucous stools, Surgery, Vomiting, Ultrasound scan abnormal

Life Threatening? Yes
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: Ultrasound scan, 18Sep2008, ISunit
CDC 'Split Type': B0538669A

Write-up: This case was reported by a physician and described the occurrence of ileocolic intussusception in a 3-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). On 13 September 2008 the subject received 1st dose of ROTARIX (unknown) lot number not provided. On 18 September 2008, 5 days after vaccination with ROTARIX, the subject presented severe vomiting enough to be hospitalized. The subject cried excessively and passed jelly currant stools. Relevant test included ultrasonography which showed ileocolic intussusception. The following day in the morning the subject underwent a surgery. The subject was hospitalised and the physician considered the events were life threatening and clinically significant (or requiring intervention). At the time of reporting the events were unresolved. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 2/14/2018

VAERS ID: 326448 Before After
VAERS Form:1
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-09-13
Onset:2008-09-18
Submitted:2008-09-29
Entered:2008-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Crying, Haematochezia, Intussusception, Mucous stools, Surgery, Vomiting, Ultrasound scan abnormal

Life Threatening? Yes
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: Ultrasound scan, 18Sep2008, ISunit
CDC 'Split Type': B0538669A

Write-up: This case was reported by a physician and described the occurrence of ileocolic intussusception in a 3-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). On 13 September 2008 the subject received 1st dose of ROTARIX (unknown) lot number not provided. On 18 September 2008, 5 days after vaccination with ROTARIX, the subject presented severe vomiting enough to be hospitalized. The subject cried excessively and passed jelly currant stools. Relevant test included ultrasonography which showed ileocolic intussusception. The following day in the morning the subject underwent a surgery. The subject was hospitalised and the physician considered the events were life threatening and clinically significant (or requiring intervention). At the time of reporting the events were unresolved. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 6/14/2018

VAERS ID: 326448 Before After
VAERS Form:1
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-09-13
Onset:2008-09-18
Submitted:2008-09-29
Entered:2008-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Crying, Haematochezia, Intussusception, Mucous stools, Surgery, Vomiting, Ultrasound scan abnormal

Life Threatening? Yes
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: Ultrasound scan, 18Sep2008, ISunit
CDC 'Split Type': B0538669A

Write-up: This case was reported by a physician and described the occurrence of ileocolic intussusception in a 3-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). On 13 September 2008 the subject received 1st dose of ROTARIX (unknown) lot number not provided. On 18 September 2008, 5 days after vaccination with ROTARIX, the subject presented severe vomiting enough to be hospitalized. The subject cried excessively and passed jelly currant stools. Relevant test included ultrasonography which showed ileocolic intussusception. The following day in the morning the subject underwent a surgery. The subject was hospitalised and the physician considered the events were life threatening and clinically significant (or requiring intervention). At the time of reporting the events were unresolved. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 8/14/2018

VAERS ID: 326448 Before After
VAERS Form:1
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-09-13
Onset:2008-09-18
Submitted:2008-09-29
Entered:2008-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Crying, Haematochezia, Intussusception, Mucous stools, Surgery, Vomiting, Ultrasound scan abnormal

Life Threatening? Yes
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: Ultrasound scan, 18Sep2008, ISunit
CDC 'Split Type': B0538669A

Write-up: This case was reported by a physician and described the occurrence of ileocolic intussusception in a 3-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). On 13 September 2008 the subject received 1st dose of ROTARIX (unknown) lot number not provided. On 18 September 2008, 5 days after vaccination with ROTARIX, the subject presented severe vomiting enough to be hospitalized. The subject cried excessively and passed jelly currant stools. Relevant test included ultrasonography which showed ileocolic intussusception. The following day in the morning the subject underwent a surgery. The subject was hospitalised and the physician considered the events were life threatening and clinically significant (or requiring intervention). At the time of reporting the events were unresolved. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 9/14/2018

VAERS ID: 326448 Before After
VAERS Form:1
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-09-13
Onset:2008-09-18
Submitted:2008-09-29
Entered:2008-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Crying, Haematochezia, Intussusception, Mucous stools, Surgery, Vomiting, Ultrasound scan abnormal

Life Threatening? Yes
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: Ultrasound scan, 18Sep2008, ISunit
CDC 'Split Type': B0538669A

Write-up: This case was reported by a physician and described the occurrence of ileocolic intussusception in a 3-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). On 13 September 2008 the subject received 1st dose of ROTARIX (unknown) lot number not provided. On 18 September 2008, 5 days after vaccination with ROTARIX, the subject presented severe vomiting enough to be hospitalized. The subject cried excessively and passed jelly currant stools. Relevant test included ultrasonography which showed ileocolic intussusception. The following day in the morning the subject underwent a surgery. The subject was hospitalised and the physician considered the events were life threatening and clinically significant (or requiring intervention). At the time of reporting the events were unresolved. The physician considered the events were possibly related to vaccination with ROTARIX.

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