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This is VAERS ID 333667

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 333667
VAERS Form:
Age:0.4
Gender:Male
Location:Foreign
Vaccinated:2008-06-24
Onset:2008-11-21
Submitted:2008-12-02
Entered:2008-12-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Barium enema abnormal, Intussusception, Irritability, Laparotomy, Vomiting, X-ray abnormal, Ultrasound abdomen abnormal, Abdominal X-ray

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: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 21Nov2008, IS; Ultrasound abdomen, 21Nov2008, IS
CDC 'Split Type': B0547992A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of ileocolic intussusception in a 9-month-old male subject who was vaccinated with ROTARIX, (GlaxoSmithKline). Previous and/or concurrent vaccination included ROTARIX; GlaxoSmithKline; oral given on 15 April 2008. On 24 June 2008 the subject received 2nd dose of ROTARIX (oral). On 21 November 2008, 150 days after vaccination with ROTARIX, the subject experienced irritability, abdominal pain and biliary vomiting. Abdominal x-ray showed a probable intussusception. Abdominal ultrasound and barium enema confirmed the diagnosis without reducing it. The same day the subject was admitted to the emergency room without clinical signs of intussusception. At physical examination only bowel was study. Laparotomy was done. ileocolic intussusception was confirmed and it was resolved by taxis without complications. On 23 November 2008 the subject was discharged fully recovered and in good clinical conditions. The subject was hospitalized for 3 days and the physician considered the events were clinically significant (or requiring intervention). The subject was treated with cefotaxime, Metamizole, midazolam, Ranitidine. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 5/13/2013

VAERS ID: 333667 Before After
VAERS Form:
Age:0.4
Gender:Male
Location:Foreign
Vaccinated:2008-06-24
Onset:2008-11-21
Submitted:2008-12-02
Entered:2008-12-02
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: Abdominal pain, Barium enema abnormal, Intussusception, Irritability, Laparotomy, Vomiting, X-ray abnormal, Ultrasound abdomen abnormal, Abdominal X-ray

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: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 21Nov2008, IS; Ultrasound abdomen, 21Nov2008, IS
CDC 'Split Type': B0547992A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of ileocolic intussusception in a 9-month-old male subject who was vaccinated with ROTARIX, (GlaxoSmithKline). Previous and/or concurrent vaccination included ROTARIX; GlaxoSmithKline; oral given on 15 April 2008. On 24 June 2008 the subject received 2nd dose of ROTARIX (oral). On 21 November 2008, 150 days after vaccination with ROTARIX, the subject experienced irritability, abdominal pain and biliary vomiting. Abdominal x-ray showed a probable intussusception. Abdominal ultrasound and barium enema confirmed the diagnosis without reducing it. The same day the subject was admitted to the emergency room without clinical signs of intussusception. At physical examination only bowel was study. Laparotomy was done. ileocolic intussusception was confirmed and it was resolved by taxis without complications. On 23 November 2008 the subject was discharged fully recovered and in good clinical conditions. The subject was hospitalized for 3 days and the physician considered the events were clinically significant (or requiring intervention). The subject was treated with cefotaxime, Metamizole, midazolam, Ranitidine. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 9/14/2017

VAERS ID: 333667 Before After
VAERS Form:(blank) 1
Age:0.4
Gender:Male
Location:Foreign
Vaccinated:2008-06-24
Onset:2008-11-21
Submitted:2008-12-02
Entered:2008-12-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 2 - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Barium enema abnormal, Intussusception, Irritability, Laparotomy, Vomiting, X-ray abnormal, Ultrasound abdomen abnormal, Abdominal X-ray

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: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 21Nov2008, IS; Ultrasound abdomen, 21Nov2008, IS
CDC 'Split Type': B0547992A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of ileocolic intussusception in a 9-month-old male subject who was vaccinated with ROTARIX, (GlaxoSmithKline). Previous and/or concurrent vaccination included ROTARIX; GlaxoSmithKline; oral given on 15 April 2008. On 24 June 2008 the subject received 2nd dose of ROTARIX (oral). On 21 November 2008, 150 days after vaccination with ROTARIX, the subject experienced irritability, abdominal pain and biliary vomiting. Abdominal x-ray showed a probable intussusception. Abdominal ultrasound and barium enema confirmed the diagnosis without reducing it. The same day the subject was admitted to the emergency room without clinical signs of intussusception. At physical examination only bowel was study. Laparotomy was done. ileocolic intussusception was confirmed and it was resolved by taxis without complications. On 23 November 2008 the subject was discharged fully recovered and in good clinical conditions. The subject was hospitalized for 3 days and the physician considered the events were clinically significant (or requiring intervention). The subject was treated with cefotaxime, Metamizole, midazolam, Ranitidine. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 2/14/2018

VAERS ID: 333667 Before After
VAERS Form:1
Age:0.4
Gender:Male
Location:Foreign
Vaccinated:2008-06-24
Onset:2008-11-21
Submitted:2008-12-02
Entered:2008-12-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 2 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Barium enema abnormal, Intussusception, Irritability, Laparotomy, Vomiting, X-ray abnormal, Ultrasound abdomen abnormal, Abdominal X-ray

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: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 21Nov2008, IS; Ultrasound abdomen, 21Nov2008, IS
CDC 'Split Type': B0547992A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of ileocolic intussusception in a 9-month-old male subject who was vaccinated with ROTARIX, (GlaxoSmithKline). Previous and/or concurrent vaccination included ROTARIX; GlaxoSmithKline; oral given on 15 April 2008. On 24 June 2008 the subject received 2nd dose of ROTARIX (oral). On 21 November 2008, 150 days after vaccination with ROTARIX, the subject experienced irritability, abdominal pain and biliary vomiting. Abdominal x-ray showed a probable intussusception. Abdominal ultrasound and barium enema confirmed the diagnosis without reducing it. The same day the subject was admitted to the emergency room without clinical signs of intussusception. At physical examination only bowel was study. Laparotomy was done. ileocolic intussusception was confirmed and it was resolved by taxis without complications. On 23 November 2008 the subject was discharged fully recovered and in good clinical conditions. The subject was hospitalized for 3 days and the physician considered the events were clinically significant (or requiring intervention). The subject was treated with cefotaxime, Metamizole, midazolam, Ranitidine. The physician considered the events were possibly related to vaccination with ROTARIX.


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