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This is VAERS ID 334089

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 334089
VAERS Form:
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-08-18
Onset:2008-10-04
Submitted:2008-12-05
Entered:2008-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal distension, Abdominal mass, Abdominal pain, Activated partial thromboplastin time normal, Barium enema, Haematochezia, Haematocrit normal, Haemoglobin normal, Intussusception, Irritability, Mucous stools, Pallor, Prothrombin time normal, Vomiting, X-ray 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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Healthy baby
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 05Oct2008, see text; Activated partial thromboplast, 05Oct-2008, 35.1s; Hematocrit, 05Oct2008, 36.8%; Hemoglobin, 05Oct2008, 12.1g/dl; Prothrombin time, 05Oct2008, 12.5s
CDC 'Split Type': B0548938A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 5-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). Previous and/or concurrent vaccination included ROTARIX; GlaxoSmithKline; oral given on 18 June 2008. Medical conditions included a healthy baby. On 18 August 2008 the subject received 2nd dose of ROTARIX (oral). On 4 October 2008, 47 days after vaccination with ROTARIX, the subject experienced irritability, gastro alimentary vomiting, 2 current jelly stools and abdominal pain. On 05 October 2008 the subject was admitted at the emergency room with irritability, pallor, normal hydration, abdominal palpable mass, positive dance signs and rectal tact showed current jelly stools. Relevant test included abdominal x-ray, which showed small bowel loops and right colon with distention and air in rectal ampoule. Intussusception was suspected. Therefore the same day after sedation the subject was treated with barium enema. Reduction of ileocecocolic intussusception was done successfully. The subject''s clinical evolution was favorable. On 08 October 2008 the subject was discharged in good clinical conditions. The subject was hospitalized for 4 days. The subject was treated with metronidazole, amikacin, Ranitidine, Methamizole, paracetamol. The physician considered the events were unrelated to vaccination with ROTARIX.


Changed on 5/13/2013

VAERS ID: 334089 Before After
VAERS Form:
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-08-18
Onset:2008-10-04
Submitted:2008-12-05
Entered:2008-12-05
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 distension, Abdominal mass, Abdominal pain, Activated partial thromboplastin time normal, Barium enema, Haematochezia, Haematocrit normal, Haemoglobin normal, Intussusception, Irritability, Mucous stools, Pallor, Prothrombin time normal, Vomiting, X-ray 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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Healthy baby
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 05Oct2008, see text; Activated partial thromboplast, 05Oct-2008, 35.1s; Hematocrit, 05Oct2008, 36.8%; Hemoglobin, 05Oct2008, 12.1g/dl; Prothrombin time, 05Oct2008, 12.5s
CDC 'Split Type': B0548938A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 5-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). Previous and/or concurrent vaccination included ROTARIX; GlaxoSmithKline; oral given on 18 June 2008. Medical conditions included a healthy baby. On 18 August 2008 the subject received 2nd dose of ROTARIX (oral). On 4 October 2008, 47 days after vaccination with ROTARIX, the subject experienced irritability, gastro alimentary vomiting, 2 current jelly stools and abdominal pain. On 05 October 2008 the subject was admitted at the emergency room with irritability, pallor, normal hydration, abdominal palpable mass, positive dance signs and rectal tact showed current jelly stools. Relevant test included abdominal x-ray, which showed small bowel loops and right colon with distention and air in rectal ampoule. Intussusception was suspected. Therefore the same day after sedation the subject was treated with barium enema. Reduction of ileocecocolic intussusception was done successfully. The subject''s clinical evolution was favorable. On 08 October 2008 the subject was discharged in good clinical conditions. The subject was hospitalized for 4 days. The subject was treated with metronidazole, amikacin, Ranitidine, Methamizole, paracetamol. The physician considered the events were unrelated to vaccination with ROTARIX.


Changed on 9/14/2017

VAERS ID: 334089 Before After
VAERS Form:(blank) 1
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-08-18
Onset:2008-10-04
Submitted:2008-12-05
Entered:2008-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 2 - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal distension, Abdominal mass, Abdominal pain, Activated partial thromboplastin time normal, Barium enema, Haematochezia, Haematocrit normal, Haemoglobin normal, Intussusception, Irritability, Mucous stools, Pallor, Prothrombin time normal, Vomiting, X-ray 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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Healthy baby
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 05Oct2008, see text; Activated partial thromboplast, 05Oct-2008, 35.1s; Hematocrit, 05Oct2008, 36.8%; Hemoglobin, 05Oct2008, 12.1g/dl; Prothrombin time, 05Oct2008, 12.5s
CDC 'Split Type': B0548938A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 5-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). Previous and/or concurrent vaccination included ROTARIX; GlaxoSmithKline; oral given on 18 June 2008. Medical conditions included a healthy baby. On 18 August 2008 the subject received 2nd dose of ROTARIX (oral). On 4 October 2008, 47 days after vaccination with ROTARIX, the subject experienced irritability, gastro alimentary vomiting, 2 current jelly stools and abdominal pain. On 05 October 2008 the subject was admitted at the emergency room with irritability, pallor, normal hydration, abdominal palpable mass, positive dance signs and rectal tact showed current jelly stools. Relevant test included abdominal x-ray, which showed small bowel loops and right colon with distention and air in rectal ampoule. Intussusception was suspected. Therefore the same day after sedation the subject was treated with barium enema. Reduction of ileocecocolic intussusception was done successfully. The subject''s clinical evolution was favorable. On 08 October 2008 the subject was discharged in good clinical conditions. The subject was hospitalized for 4 days. The subject was treated with metronidazole, amikacin, Ranitidine, Methamizole, paracetamol. The physician considered the events were unrelated to vaccination with ROTARIX.


Changed on 2/14/2018

VAERS ID: 334089 Before After
VAERS Form:1
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-08-18
Onset:2008-10-04
Submitted:2008-12-05
Entered:2008-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 2 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal distension, Abdominal mass, Abdominal pain, Activated partial thromboplastin time normal, Barium enema, Haematochezia, Haematocrit normal, Haemoglobin normal, Intussusception, Irritability, Mucous stools, Pallor, Prothrombin time normal, Vomiting, X-ray 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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Healthy baby
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 05Oct2008, see text; Activated partial thromboplast, 05Oct-2008, 35.1s; Hematocrit, 05Oct2008, 36.8%; Hemoglobin, 05Oct2008, 12.1g/dl; Prothrombin time, 05Oct2008, 12.5s
CDC 'Split Type': B0548938A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 5-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). Previous and/or concurrent vaccination included ROTARIX; GlaxoSmithKline; oral given on 18 June 2008. Medical conditions included a healthy baby. On 18 August 2008 the subject received 2nd dose of ROTARIX (oral). On 4 October 2008, 47 days after vaccination with ROTARIX, the subject experienced irritability, gastro alimentary vomiting, 2 current jelly stools and abdominal pain. On 05 October 2008 the subject was admitted at the emergency room with irritability, pallor, normal hydration, abdominal palpable mass, positive dance signs and rectal tact showed current jelly stools. Relevant test included abdominal x-ray, which showed small bowel loops and right colon with distention and air in rectal ampoule. Intussusception was suspected. Therefore the same day after sedation the subject was treated with barium enema. Reduction of ileocecocolic intussusception was done successfully. The subject''s clinical evolution was favorable. On 08 October 2008 the subject was discharged in good clinical conditions. The subject was hospitalized for 4 days. The subject was treated with metronidazole, amikacin, Ranitidine, Methamizole, paracetamol. The physician considered the events were unrelated to vaccination with ROTARIX.


Changed on 6/14/2018

VAERS ID: 334089 Before After
VAERS Form:1
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-08-18
Onset:2008-10-04
Submitted:2008-12-05
Entered:2008-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 2 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal distension, Abdominal mass, Abdominal pain, Activated partial thromboplastin time normal, Barium enema, Haematochezia, Haematocrit normal, Haemoglobin normal, Intussusception, Irritability, Mucous stools, Pallor, Prothrombin time normal, Vomiting, X-ray 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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Healthy baby
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, 05Oct2008, see text; Activated partial thromboplast, 05Oct-2008, 35.1s; Hematocrit, 05Oct2008, 36.8%; Hemoglobin, 05Oct2008, 12.1g/dl; Prothrombin time, 05Oct2008, 12.5s
CDC 'Split Type': B0548938A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 5-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). Previous and/or concurrent vaccination included ROTARIX; GlaxoSmithKline; oral given on 18 June 2008. Medical conditions included a healthy baby. On 18 August 2008 the subject received 2nd dose of ROTARIX (oral). On 4 October 2008, 47 days after vaccination with ROTARIX, the subject experienced irritability, gastro alimentary vomiting, 2 current jelly stools and abdominal pain. On 05 October 2008 the subject was admitted at the emergency room with irritability, pallor, normal hydration, abdominal palpable mass, positive dance signs and rectal tact showed current jelly stools. Relevant test included abdominal x-ray, which showed small bowel loops and right colon with distention and air in rectal ampoule. Intussusception was suspected. Therefore the same day after sedation the subject was treated with barium enema. Reduction of ileocecocolic intussusception was done successfully. The subject''s clinical evolution was favorable. On 08 October 2008 the subject was discharged in good clinical conditions. The subject was hospitalized for 4 days. The subject was treated with metronidazole, amikacin, Ranitidine, Methamizole, paracetamol. The physician considered the events were unrelated to vaccination with ROTARIX.

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