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This is VAERS ID 329449

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 329449
VAERS Form:
Age:0.5
Gender:Male
Location:Foreign
Vaccinated:2008-08-02
Onset:2008-09-10
Submitted:2008-10-21
Entered:2008-10-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Haematochezia, Intussusception, Mucous stools, Pyrexia, Surgery, Vomiting

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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0542196A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 7-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). Previous and/or concurrent vaccination included ROTARIX (GlaxoSmithKline, oral) given on 23 June 2008. On 2 August 2008, the subject received 2nd dose of ROTARIX (oral). Lot number not provided. On 10 September 2008, 39 days after vaccination with ROTARIX, the subject started with vomiting and after experienced 8 currant jelly stools and fever. The patient was admitted at hospital with a suspicion of intussusception. A surgery was performed and the subject was hospitalised for 5 days. At the time of reporting the events were resolved. On 30 September, the subject went to the doctor for follow up and was in good general condition. The physician considered the events were almost certainly related to vaccination with ROTARIX.


Changed on 5/13/2013

VAERS ID: 329449 Before After
VAERS Form:
Age:0.5
Gender:Male
Location:Foreign
Vaccinated:2008-08-02
Onset:2008-09-10
Submitted:2008-10-21
Entered:2008-10-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 - / PO
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Haematochezia, Intussusception, Mucous stools, Pyrexia, Surgery, Vomiting

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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0542196A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 7-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). Previous and/or concurrent vaccination included ROTARIX (GlaxoSmithKline, oral) given on 23 June 2008. On 2 August 2008, the subject received 2nd dose of ROTARIX (oral). Lot number not provided. On 10 September 2008, 39 days after vaccination with ROTARIX, the subject started with vomiting and after experienced 8 currant jelly stools and fever. The patient was admitted at hospital with a suspicion of intussusception. A surgery was performed and the subject was hospitalised for 5 days. At the time of reporting the events were resolved. On 30 September, the subject went to the doctor for follow up and was in good general condition. The physician considered the events were almost certainly related to vaccination with ROTARIX.


Changed on 9/14/2017

VAERS ID: 329449 Before After
VAERS Form:(blank) 1
Age:0.5
Gender:Male
Location:Foreign
Vaccinated:2008-08-02
Onset:2008-09-10
Submitted:2008-10-21
Entered:2008-10-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 2 - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Haematochezia, Intussusception, Mucous stools, Pyrexia, Surgery, Vomiting

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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0542196A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 7-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). Previous and/or concurrent vaccination included ROTARIX (GlaxoSmithKline, oral) given on 23 June 2008. On 2 August 2008, the subject received 2nd dose of ROTARIX (oral). Lot number not provided. On 10 September 2008, 39 days after vaccination with ROTARIX, the subject started with vomiting and after experienced 8 currant jelly stools and fever. The patient was admitted at hospital with a suspicion of intussusception. A surgery was performed and the subject was hospitalised for 5 days. At the time of reporting the events were resolved. On 30 September, the subject went to the doctor for follow up and was in good general condition. The physician considered the events were almost certainly related to vaccination with ROTARIX.


Changed on 2/14/2018

VAERS ID: 329449 Before After
VAERS Form:1
Age:0.5
Gender:Male
Location:Foreign
Vaccinated:2008-08-02
Onset:2008-09-10
Submitted:2008-10-21
Entered:2008-10-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 2 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Haematochezia, Intussusception, Mucous stools, Pyrexia, Surgery, Vomiting

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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0542196A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 7-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). Previous and/or concurrent vaccination included ROTARIX (GlaxoSmithKline, oral) given on 23 June 2008. On 2 August 2008, the subject received 2nd dose of ROTARIX (oral). Lot number not provided. On 10 September 2008, 39 days after vaccination with ROTARIX, the subject started with vomiting and after experienced 8 currant jelly stools and fever. The patient was admitted at hospital with a suspicion of intussusception. A surgery was performed and the subject was hospitalised for 5 days. At the time of reporting the events were resolved. On 30 September, the subject went to the doctor for follow up and was in good general condition. The physician considered the events were almost certainly related to vaccination with ROTARIX.


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