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This is VAERS ID 330794

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 330794
VAERS Form:
Age:0.4
Gender:Male
Location:Foreign
Vaccinated:2008-09-05
Onset:2008-10-02
Submitted:2008-10-30
Entered:2008-10-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 0 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Barium double contrast, Blood culture, Crying, Flushing, Intussusception, Rectal haemorrhage, Surgery, X-ray abnormal, Laboratory test, Blood electrolytes, Abdominal X-ray, Blood test, Oral intake reduced

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: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 02Oct2008, Abnormal unit; Air contrast barium enema, 02Oct2008, Abnormal unit; Blood test, unknown; Serum electrolytes NOS, unknown
CDC 'Split Type': B0541544A

Write-up: This case was reported by a physician and described the occurrence of ileocolic intussusception in a 5-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). On 5 September 2008, the subject received 1st dose of ROTARIX (oral), lot number not provided. On 2 October 2008, 27 days after vaccination with ROTARIX, the subject experienced ileocolic intussusception. The event was confirmed by clinical features, abdomen x-ray and air contrast enema which showed an ileocolic intussusception. Surgery was performed without intestine resection. The physician considered the event was life threatening. The reporter considered the events were probably related to vaccination with ROTARIX. At the time of reporting the outcome of the events was unspecified. Follow up received on 23 October 2008: The signs and symptoms were decreased oral intake for 1 day along with excessive crying and periodic abdominal pain (the subject''s face became flushing during that episode and he pulled his legs) which lasted 2-3 minutes and got resolved by itself. The subject had 4-5 episodes of rectal bleeding (typical currant jelly color). Other relevant test included CP, serum electrolytes, blood C/S. The subject was treated with FLAGYL, AMPICILLIN, GENTAMYCIN and intravenous fluids. On 02 October 2008 surgical correction (manual reduction) was done. The subject''s condition improved and he was discharged on 07 October 2008 in OPD after 1 week.


Changed on 5/13/2013

VAERS ID: 330794 Before After
VAERS Form:
Age:0.4
Gender:Male
Location:Foreign
Vaccinated:2008-09-05
Onset:2008-10-02
Submitted:2008-10-30
Entered:2008-10-30
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 double contrast, Blood culture, Crying, Flushing, Intussusception, Rectal haemorrhage, Surgery, X-ray abnormal, Laboratory test, Blood electrolytes, Abdominal X-ray, Blood test, Oral intake reduced

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: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 02Oct2008, Abnormal unit; Air contrast barium enema, 02Oct2008, Abnormal unit; Blood test, unknown; Serum electrolytes NOS, unknown
CDC 'Split Type': B0541544A

Write-up: This case was reported by a physician and described the occurrence of ileocolic intussusception in a 5-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). On 5 September 2008, the subject received 1st dose of ROTARIX (oral), lot number not provided. On 2 October 2008, 27 days after vaccination with ROTARIX, the subject experienced ileocolic intussusception. The event was confirmed by clinical features, abdomen x-ray and air contrast enema which showed an ileocolic intussusception. Surgery was performed without intestine resection. The physician considered the event was life threatening. The reporter considered the events were probably related to vaccination with ROTARIX. At the time of reporting the outcome of the events was unspecified. Follow up received on 23 October 2008: The signs and symptoms were decreased oral intake for 1 day along with excessive crying and periodic abdominal pain (the subject''s face became flushing during that episode and he pulled his legs) which lasted 2-3 minutes and got resolved by itself. The subject had 4-5 episodes of rectal bleeding (typical currant jelly color). Other relevant test included CP, serum electrolytes, blood C/S. The subject was treated with FLAGYL, AMPICILLIN, GENTAMYCIN and intravenous fluids. On 02 October 2008 surgical correction (manual reduction) was done. The subject''s condition improved and he was discharged on 07 October 2008 in OPD after 1 week.


Changed on 9/14/2017

VAERS ID: 330794 Before After
VAERS Form:(blank) 1
Age:0.4
Gender:Male
Location:Foreign
Vaccinated:2008-09-05
Onset:2008-10-02
Submitted:2008-10-30
Entered:2008-10-30
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 double contrast, Blood culture, Crying, Flushing, Intussusception, Rectal haemorrhage, Surgery, X-ray abnormal, Laboratory test, Blood electrolytes, Abdominal X-ray, Blood test, Oral intake reduced

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: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 02Oct2008, Abnormal unit; Air contrast barium enema, 02Oct2008, Abnormal unit; Blood test, unknown; Serum electrolytes NOS, unknown
CDC 'Split Type': B0541544A

Write-up: This case was reported by a physician and described the occurrence of ileocolic intussusception in a 5-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). On 5 September 2008, the subject received 1st dose of ROTARIX (oral), lot number not provided. On 2 October 2008, 27 days after vaccination with ROTARIX, the subject experienced ileocolic intussusception. The event was confirmed by clinical features, abdomen x-ray and air contrast enema which showed an ileocolic intussusception. Surgery was performed without intestine resection. The physician considered the event was life threatening. The reporter considered the events were probably related to vaccination with ROTARIX. At the time of reporting the outcome of the events was unspecified. Follow up received on 23 October 2008: The signs and symptoms were decreased oral intake for 1 day along with excessive crying and periodic abdominal pain (the subject''s face became flushing during that episode and he pulled his legs) which lasted 2-3 minutes and got resolved by itself. The subject had 4-5 episodes of rectal bleeding (typical currant jelly color). Other relevant test included CP, serum electrolytes, blood C/S. The subject was treated with FLAGYL, AMPICILLIN, GENTAMYCIN and intravenous fluids. On 02 October 2008 surgical correction (manual reduction) was done. The subject''s condition improved and he was discharged on 07 October 2008 in OPD after 1 week.


Changed on 2/14/2018

VAERS ID: 330794 Before After
VAERS Form:1
Age:0.4
Gender:Male
Location:Foreign
Vaccinated:2008-09-05
Onset:2008-10-02
Submitted:2008-10-30
Entered:2008-10-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Barium double contrast, Blood culture, Crying, Flushing, Intussusception, Rectal haemorrhage, Surgery, X-ray abnormal, Laboratory test, Blood electrolytes, Abdominal X-ray, Blood test, Oral intake reduced

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: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 02Oct2008, Abnormal unit; Air contrast barium enema, 02Oct2008, Abnormal unit; Blood test, unknown; Serum electrolytes NOS, unknown
CDC 'Split Type': B0541544A

Write-up: This case was reported by a physician and described the occurrence of ileocolic intussusception in a 5-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). On 5 September 2008, the subject received 1st dose of ROTARIX (oral), lot number not provided. On 2 October 2008, 27 days after vaccination with ROTARIX, the subject experienced ileocolic intussusception. The event was confirmed by clinical features, abdomen x-ray and air contrast enema which showed an ileocolic intussusception. Surgery was performed without intestine resection. The physician considered the event was life threatening. The reporter considered the events were probably related to vaccination with ROTARIX. At the time of reporting the outcome of the events was unspecified. Follow up received on 23 October 2008: The signs and symptoms were decreased oral intake for 1 day along with excessive crying and periodic abdominal pain (the subject''s face became flushing during that episode and he pulled his legs) which lasted 2-3 minutes and got resolved by itself. The subject had 4-5 episodes of rectal bleeding (typical currant jelly color). Other relevant test included CP, serum electrolytes, blood C/S. The subject was treated with FLAGYL, AMPICILLIN, GENTAMYCIN and intravenous fluids. On 02 October 2008 surgical correction (manual reduction) was done. The subject''s condition improved and he was discharged on 07 October 2008 in OPD after 1 week.


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