National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 330202

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 330202
VAERS Form:
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2007-01-19
Onset:2007-01-23
Submitted:2008-10-27
Entered:2008-10-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - - / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0526919A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 3-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). On 19 January 2007 the subject received unspecified dose of ROTARIX (oral). On 23 January 2007, 4 days after vaccination with ROTARIX, the subject experienced intussusception. The subject was hospitalised and the physician considered the event was clinically significant (or requiring intervention). At the time of reporting the event was resolved by taxis. The physician considered the event was almost certainly related to vaccination with ROTARIX. After several attempts no further information could be obtained. Therefore on 24 October 2008 this case has been closed.


Changed on 5/13/2013

VAERS ID: 330202 Before After
VAERS Form:
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2007-01-19
Onset:2007-01-23
Submitted:2008-10-27
Entered:2008-10-27
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

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0526919A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 3-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). On 19 January 2007 the subject received unspecified dose of ROTARIX (oral). On 23 January 2007, 4 days after vaccination with ROTARIX, the subject experienced intussusception. The subject was hospitalised and the physician considered the event was clinically significant (or requiring intervention). At the time of reporting the event was resolved by taxis. The physician considered the event was almost certainly related to vaccination with ROTARIX. After several attempts no further information could be obtained. Therefore on 24 October 2008 this case has been closed.


Changed on 9/14/2017

VAERS ID: 330202 Before After
VAERS Form:(blank) 1
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2007-01-19
Onset:2007-01-23
Submitted:2008-10-27
Entered:2008-10-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - UNK - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0526919A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 3-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). On 19 January 2007 the subject received unspecified dose of ROTARIX (oral). On 23 January 2007, 4 days after vaccination with ROTARIX, the subject experienced intussusception. The subject was hospitalised and the physician considered the event was clinically significant (or requiring intervention). At the time of reporting the event was resolved by taxis. The physician considered the event was almost certainly related to vaccination with ROTARIX. After several attempts no further information could be obtained. Therefore on 24 October 2008 this case has been closed.


Changed on 2/14/2018

VAERS ID: 330202 Before After
VAERS Form:1
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2007-01-19
Onset:2007-01-23
Submitted:2008-10-27
Entered:2008-10-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0526919A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 3-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). On 19 January 2007 the subject received unspecified dose of ROTARIX (oral). On 23 January 2007, 4 days after vaccination with ROTARIX, the subject experienced intussusception. The subject was hospitalised and the physician considered the event was clinically significant (or requiring intervention). At the time of reporting the event was resolved by taxis. The physician considered the event was almost certainly related to vaccination with ROTARIX. After several attempts no further information could be obtained. Therefore on 24 October 2008 this case has been closed.


Changed on 6/14/2018

VAERS ID: 330202 Before After
VAERS Form:1
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2007-01-19
Onset:2007-01-23
Submitted:2008-10-27
Entered:2008-10-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0526919A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 3-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). On 19 January 2007 the subject received unspecified dose of ROTARIX (oral). On 23 January 2007, 4 days after vaccination with ROTARIX, the subject experienced intussusception. The subject was hospitalised and the physician considered the event was clinically significant (or requiring intervention). At the time of reporting the event was resolved by taxis. The physician considered the event was almost certainly related to vaccination with ROTARIX. After several attempts no further information could be obtained. Therefore on 24 October 2008 this case has been closed.


Changed on 8/14/2018

VAERS ID: 330202 Before After
VAERS Form:1
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2007-01-19
Onset:2007-01-23
Submitted:2008-10-27
Entered:2008-10-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0526919A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 3-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). On 19 January 2007 the subject received unspecified dose of ROTARIX (oral). On 23 January 2007, 4 days after vaccination with ROTARIX, the subject experienced intussusception. The subject was hospitalised and the physician considered the event was clinically significant (or requiring intervention). At the time of reporting the event was resolved by taxis. The physician considered the event was almost certainly related to vaccination with ROTARIX. After several attempts no further information could be obtained. Therefore on 24 October 2008 this case has been closed.


Changed on 9/14/2018

VAERS ID: 330202 Before After
VAERS Form:1
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2007-01-19
Onset:2007-01-23
Submitted:2008-10-27
Entered:2008-10-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0526919A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 3-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). On 19 January 2007 the subject received unspecified dose of ROTARIX (oral). On 23 January 2007, 4 days after vaccination with ROTARIX, the subject experienced intussusception. The subject was hospitalised and the physician considered the event was clinically significant (or requiring intervention). At the time of reporting the event was resolved by taxis. The physician considered the event was almost certainly related to vaccination with ROTARIX. After several attempts no further information could be obtained. Therefore on 24 October 2008 this case has been closed.


Changed on 10/14/2018

VAERS ID: 330202 Before After
VAERS Form:1
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2007-01-19
Onset:2007-01-23
Submitted:2008-10-27
Entered:2008-10-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0526919A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 3-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). On 19 January 2007 the subject received unspecified dose of ROTARIX (oral). On 23 January 2007, 4 days after vaccination with ROTARIX, the subject experienced intussusception. The subject was hospitalised and the physician considered the event was clinically significant (or requiring intervention). At the time of reporting the event was resolved by taxis. The physician considered the event was almost certainly related to vaccination with ROTARIX. After several attempts no further information could be obtained. Therefore on 24 October 2008 this case has been closed.

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=330202&WAYBACKHISTORY=ON


Copyright © 2018 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166