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This is VAERS ID 333514

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 333514
VAERS Form:
Age:0.2
Gender:Male
Location:Foreign
Vaccinated:2008-11-08
Onset:2008-11-16
Submitted:2008-12-01
Entered:2008-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA614A / 1 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Barium enema, Haematochezia, Intussusception, Surgery, X-ray abnormal, Abdominal X-ray

Life Threatening? No
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: Abdominal X-ray, Nov2008, Abnormal
CDC 'Split Type': B0547195A

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). Previous and/or concurrent vaccination included ROTARIX; GlaxoSmithKline given on 27 September 2008. On 8 November 2008, the subject received 2nd dose of ROTARIX (oral). On 16 November 2008, 8 days after vaccination with ROTARIX, the subject experienced bloody stools and abdominal pain, leading to hospitalisation, intussusception. The physician considered the events were clinically significant (or requiring intervention). The abdomen X-ray revealed an intussusception. On 17 November 2008, the subject was unsuccessfully treated with barium salt. The same day, surgery was performed. At the time of reporting the subject was still hospitalised and the events are improving. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 5/13/2013

VAERS ID: 333514 Before After
VAERS Form:
Age:0.2
Gender:Male
Location:Foreign
Vaccinated:2008-11-08
Onset:2008-11-16
Submitted:2008-12-01
Entered:2008-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA614A / 1 - / PO
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA614A / 1 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Barium enema, Haematochezia, Intussusception, Surgery, X-ray abnormal, Abdominal X-ray

Life Threatening? No
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: Abdominal X-ray, Nov2008, Abnormal
CDC 'Split Type': B0547195A

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). Previous and/or concurrent vaccination included ROTARIX; GlaxoSmithKline given on 27 September 2008. On 8 November 2008, the subject received 2nd dose of ROTARIX (oral). On 16 November 2008, 8 days after vaccination with ROTARIX, the subject experienced bloody stools and abdominal pain, leading to hospitalisation, intussusception. The physician considered the events were clinically significant (or requiring intervention). The abdomen X-ray revealed an intussusception. On 17 November 2008, the subject was unsuccessfully treated with barium salt. The same day, surgery was performed. At the time of reporting the subject was still hospitalised and the events are improving. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 9/14/2017

VAERS ID: 333514 Before After
VAERS Form:(blank) 1
Age:0.2
Gender:Male
Location:Foreign
Vaccinated:2008-11-08
Onset:2008-11-16
Submitted:2008-12-01
Entered:2008-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA614A / 1 2 - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Barium enema, Haematochezia, Intussusception, Surgery, X-ray abnormal, Abdominal X-ray

Life Threatening? No
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: Abdominal X-ray, Nov2008, Abnormal
CDC 'Split Type': B0547195A

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). Previous and/or concurrent vaccination included ROTARIX; GlaxoSmithKline given on 27 September 2008. On 8 November 2008, the subject received 2nd dose of ROTARIX (oral). On 16 November 2008, 8 days after vaccination with ROTARIX, the subject experienced bloody stools and abdominal pain, leading to hospitalisation, intussusception. The physician considered the events were clinically significant (or requiring intervention). The abdomen X-ray revealed an intussusception. On 17 November 2008, the subject was unsuccessfully treated with barium salt. The same day, surgery was performed. At the time of reporting the subject was still hospitalised and the events are improving. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 2/14/2018

VAERS ID: 333514 Before After
VAERS Form:1
Age:0.2
Gender:Male
Location:Foreign
Vaccinated:2008-11-08
Onset:2008-11-16
Submitted:2008-12-01
Entered:2008-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA614A / 2 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Barium enema, Haematochezia, Intussusception, Surgery, X-ray abnormal, Abdominal X-ray

Life Threatening? No
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: Abdominal X-ray, Nov2008, Abnormal
CDC 'Split Type': B0547195A

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). Previous and/or concurrent vaccination included ROTARIX; GlaxoSmithKline given on 27 September 2008. On 8 November 2008, the subject received 2nd dose of ROTARIX (oral). On 16 November 2008, 8 days after vaccination with ROTARIX, the subject experienced bloody stools and abdominal pain, leading to hospitalisation, intussusception. The physician considered the events were clinically significant (or requiring intervention). The abdomen X-ray revealed an intussusception. On 17 November 2008, the subject was unsuccessfully treated with barium salt. The same day, surgery was performed. At the time of reporting the subject was still hospitalised and the events are improving. The physician considered the events were possibly related to vaccination with ROTARIX.


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