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This is VAERS ID 332888

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 332888
VAERS Form:
Age:0.5
Gender:Female
Location:Foreign
Vaccinated:2008-10-13
Onset:2008-10-16
Submitted:2008-11-20
Entered:2008-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Haematochezia, Intussusception, Pyrexia, Surgery, Haemorrhage

Life Threatening? Yes
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': B0546499A

Write-up: This case was reported by a physician and described the occurrence of invagination of intestine in a 7-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). Previous vaccination included ROTARIX (GlaxoSmithKline, oral) given on an unspecified date. On 13 October 2008, the subject received 2nd dose of ROTARIX (oral). Lot number not provided. At an unspecified time after vaccination with ROTARIX, the subject experienced invagination of intestine. The subject was hospitalised and had a surgery. At the time of reporting the outcome of the event was unspecified. Follow up information received on 17 November 2008 from the physician: On 16 October 2008, 3 days after vaccination with ROTARIX, the subject experienced fever, bleeding and bloody stools. The subject was hospitalised. Invagination of intestine was diagnosed and resolved by surgery on 20 October 2008. The physician considered the events were life threatening and clinically significant (or requiring intervention). On 20 October 2008, the events were resolved.


Changed on 5/13/2013

VAERS ID: 332888 Before After
VAERS Form:
Age:0.5
Gender:Female
Location:Foreign
Vaccinated:2008-10-13
Onset:2008-10-16
Submitted:2008-11-20
Entered:2008-11-20
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, Pyrexia, Surgery, Haemorrhage

Life Threatening? Yes
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': B0546499A

Write-up: This case was reported by a physician and described the occurrence of invagination of intestine in a 7-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). Previous vaccination included ROTARIX (GlaxoSmithKline, oral) given on an unspecified date. On 13 October 2008, the subject received 2nd dose of ROTARIX (oral). Lot number not provided. At an unspecified time after vaccination with ROTARIX, the subject experienced invagination of intestine. The subject was hospitalised and had a surgery. At the time of reporting the outcome of the event was unspecified. Follow up information received on 17 November 2008 from the physician: On 16 October 2008, 3 days after vaccination with ROTARIX, the subject experienced fever, bleeding and bloody stools. The subject was hospitalised. Invagination of intestine was diagnosed and resolved by surgery on 20 October 2008. The physician considered the events were life threatening and clinically significant (or requiring intervention). On 20 October 2008, the events were resolved.


Changed on 9/14/2017

VAERS ID: 332888 Before After
VAERS Form:(blank) 1
Age:0.5
Gender:Female
Location:Foreign
Vaccinated:2008-10-13
Onset:2008-10-16
Submitted:2008-11-20
Entered:2008-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 2 - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Haematochezia, Intussusception, Pyrexia, Surgery, Haemorrhage

Life Threatening? Yes
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': B0546499A

Write-up: This case was reported by a physician and described the occurrence of invagination of intestine in a 7-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). Previous vaccination included ROTARIX (GlaxoSmithKline, oral) given on an unspecified date. On 13 October 2008, the subject received 2nd dose of ROTARIX (oral). Lot number not provided. At an unspecified time after vaccination with ROTARIX, the subject experienced invagination of intestine. The subject was hospitalised and had a surgery. At the time of reporting the outcome of the event was unspecified. Follow up information received on 17 November 2008 from the physician: On 16 October 2008, 3 days after vaccination with ROTARIX, the subject experienced fever, bleeding and bloody stools. The subject was hospitalised. Invagination of intestine was diagnosed and resolved by surgery on 20 October 2008. The physician considered the events were life threatening and clinically significant (or requiring intervention). On 20 October 2008, the events were resolved.


Changed on 2/14/2018

VAERS ID: 332888 Before After
VAERS Form:1
Age:0.5
Gender:Female
Location:Foreign
Vaccinated:2008-10-13
Onset:2008-10-16
Submitted:2008-11-20
Entered:2008-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 2 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Haematochezia, Intussusception, Pyrexia, Surgery, Haemorrhage

Life Threatening? Yes
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': B0546499A

Write-up: This case was reported by a physician and described the occurrence of invagination of intestine in a 7-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). Previous vaccination included ROTARIX (GlaxoSmithKline, oral) given on an unspecified date. On 13 October 2008, the subject received 2nd dose of ROTARIX (oral). Lot number not provided. At an unspecified time after vaccination with ROTARIX, the subject experienced invagination of intestine. The subject was hospitalised and had a surgery. At the time of reporting the outcome of the event was unspecified. Follow up information received on 17 November 2008 from the physician: On 16 October 2008, 3 days after vaccination with ROTARIX, the subject experienced fever, bleeding and bloody stools. The subject was hospitalised. Invagination of intestine was diagnosed and resolved by surgery on 20 October 2008. The physician considered the events were life threatening and clinically significant (or requiring intervention). On 20 October 2008, the events were resolved.


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