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This is VAERS ID 334090

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 334090
VAERS Form:
Age:0.3
Gender:Female
Location:Foreign
Vaccinated:2008-10-21
Onset:2008-11-01
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, Blood creatinine normal, Blood glucose increased, Blood potassium normal, Blood sodium normal, Haematochezia, Haemoglobin normal, International normalised ratio normal, Intussusception, Irritability, Pallor, Prothrombin time normal, Surgery, Vomiting, White blood cell count, X-ray abnormal, Neutrophil percentage, Lymphocyte percentage, 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)? Yes
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, 02Nov2008, see text; Blood glucose, 02Nov2008, 117mg/dl; Creatinine, 02Nov2008, 0.4mg/dl; Hemoglobin, 02Nov2008, 10.8g/dl; International normalized ratio, 02Nov2008, 1.03UI; Leukocyte count NOS, 02Nov2008, 12500mm2; Lymphoc
CDC 'Split Type': B0549012A

Write-up: This case was reported by a physician in the frame of a PASS study and described the occurrence of intussusception in a 4-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). Previous and/or concurrent vaccination included live attenuated human rotavirus vaccine; GlaxoSmithKline; oral given on 21 August 2008. On 21 October 2008 the subject received 2nd dose of ROTARIX (oral). On 1 November 2008, 11 days after vaccination with ROTARIX, the subject experienced gastro alimentary vomiting, gastro biliar vomiting and bloody stools. On 02 November 2008 the subject was admitted to the emergency room with pallor, irritability, abdominal mass and rectal tact with fresh blood. Abdominal x-ray showed intestinal distention. Intussusception was suspected. The same day subject underwent a surgery showing evidence of ileocecocolic position. The event was resolved with taxis without complication. The subject''s clinical evolution was favorable. On 04 November 2008 the subject was discharged in franc abdominal recuperation. The subject was hospitalized for 3 days. Relevant test results included [laboratory results/hospital investigations]. The subject was treated with metronidazole, Ranitidine, amikacin and surgery. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 5/13/2013

VAERS ID: 334090 Before After
VAERS Form:
Age:0.3
Gender:Female
Location:Foreign
Vaccinated:2008-10-21
Onset:2008-11-01
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, Blood creatinine normal, Blood glucose increased, Blood potassium normal, Blood sodium normal, Haematochezia, Haemoglobin normal, International normalised ratio normal, Intussusception, Irritability, Pallor, Prothrombin time normal, Surgery, Vomiting, White blood cell count, X-ray abnormal, Neutrophil percentage, Lymphocyte percentage, 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)? Yes
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, 02Nov2008, see text; Blood glucose, 02Nov2008, 117mg/dl; Creatinine, 02Nov2008, 0.4mg/dl; Hemoglobin, 02Nov2008, 10.8g/dl; International normalized ratio, 02Nov2008, 1.03UI; Leukocyte count NOS, 02Nov2008, 12500mm2; Lymphoc
CDC 'Split Type': B0549012A

Write-up: This case was reported by a physician in the frame of a PASS study and described the occurrence of intussusception in a 4-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). Previous and/or concurrent vaccination included live attenuated human rotavirus vaccine; GlaxoSmithKline; oral given on 21 August 2008. On 21 October 2008 the subject received 2nd dose of ROTARIX (oral). On 1 November 2008, 11 days after vaccination with ROTARIX, the subject experienced gastro alimentary vomiting, gastro biliar vomiting and bloody stools. On 02 November 2008 the subject was admitted to the emergency room with pallor, irritability, abdominal mass and rectal tact with fresh blood. Abdominal x-ray showed intestinal distention. Intussusception was suspected. The same day subject underwent a surgery showing evidence of ileocecocolic position. The event was resolved with taxis without complication. The subject''s clinical evolution was favorable. On 04 November 2008 the subject was discharged in franc abdominal recuperation. The subject was hospitalized for 3 days. Relevant test results included [laboratory results/hospital investigations]. The subject was treated with metronidazole, Ranitidine, amikacin and surgery. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 4/14/2017

VAERS ID: 334090 Before After
VAERS Form:
Age:0.3
Gender:Female
Location:Foreign
Vaccinated:2008-10-21
Onset:2008-11-01
Submitted:2008-12-05
Entered:2008-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal distension, Abdominal mass, Blood creatinine normal, Blood glucose increased, Blood potassium normal, Blood sodium normal, Haematochezia, Haemoglobin normal, International normalised ratio normal, Intussusception, Irritability, Pallor, Prothrombin time normal, Surgery, Vomiting, White blood cell count, X-ray abnormal, Neutrophil percentage, Lymphocyte percentage, 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)? Yes
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, 02Nov2008, see text; Blood glucose, 02Nov2008, 117mg/dl; Creatinine, 02Nov2008, 0.4mg/dl; Hemoglobin, 02Nov2008, 10.8g/dl; International normalized ratio, 02Nov2008, 1.03UI; Leukocyte count NOS, 02Nov2008, 12500mm2; Lymphoc Lymphocytes, 02Nov2008, 36%; Neutrophils, 02Nov2008, 61%; Potassium, 02Nov2008, 4.4mEq/l; Prothrombin time, 02Nov2008, 11.7s; Sodium, 02Nov2008, 136mEq/l
CDC 'Split Type': B0549012A

Write-up: This case was reported by a physician in the frame of a PASS study and described the occurrence of intussusception in a 4-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). Previous and/or concurrent vaccination included live attenuated human rotavirus vaccine; GlaxoSmithKline; oral given on 21 August 2008. On 21 October 2008 the subject received 2nd dose of ROTARIX (oral). On 1 November 2008, 11 days after vaccination with ROTARIX, the subject experienced gastro alimentary vomiting, gastro biliar vomiting and bloody stools. On 02 November 2008 the subject was admitted to the emergency room with pallor, irritability, abdominal mass and rectal tact with fresh blood. Abdominal x-ray showed intestinal distention. Intussusception was suspected. The same day subject underwent a surgery showing evidence of ileocecocolic position. The event was resolved with taxis without complication. The subject''s clinical evolution was favorable. On 04 November 2008 the subject was discharged in franc abdominal recuperation. The subject was hospitalized for 3 days. Relevant test results included [laboratory results/hospital investigations]. The subject was treated with metronidazole, Ranitidine, amikacin and surgery. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 9/14/2017

VAERS ID: 334090 Before After
VAERS Form:(blank) 1
Age:0.3
Gender:Female
Location:Foreign
Vaccinated:2008-10-21
Onset:2008-11-01
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, Blood creatinine normal, Blood glucose increased, Blood potassium normal, Blood sodium normal, Haematochezia, Haemoglobin normal, International normalised ratio normal, Intussusception, Irritability, Pallor, Prothrombin time normal, Surgery, Vomiting, White blood cell count, X-ray abnormal, Neutrophil percentage, Lymphocyte percentage, 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)? Yes
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, 02Nov2008, see text; Blood glucose, 02Nov2008, 117mg/dl; Creatinine, 02Nov2008, 0.4mg/dl; Hemoglobin, 02Nov2008, 10.8g/dl; International normalized ratio, 02Nov2008, 1.03UI; Leukocyte count NOS, 02Nov2008, 12500mm2; Lymphocytes, 02Nov2008, 36%; Neutrophils, 02Nov2008, 61%; Potassium, 02Nov2008, 4.4mEq/l; Prothrombin time, 02Nov2008, 11.7s; Sodium, 02Nov2008, 136mEq/l
CDC 'Split Type': B0549012A

Write-up: This case was reported by a physician in the frame of a PASS study and described the occurrence of intussusception in a 4-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). Previous and/or concurrent vaccination included live attenuated human rotavirus vaccine; GlaxoSmithKline; oral given on 21 August 2008. On 21 October 2008 the subject received 2nd dose of ROTARIX (oral). On 1 November 2008, 11 days after vaccination with ROTARIX, the subject experienced gastro alimentary vomiting, gastro biliar vomiting and bloody stools. On 02 November 2008 the subject was admitted to the emergency room with pallor, irritability, abdominal mass and rectal tact with fresh blood. Abdominal x-ray showed intestinal distention. Intussusception was suspected. The same day subject underwent a surgery showing evidence of ileocecocolic position. The event was resolved with taxis without complication. The subject''s clinical evolution was favorable. On 04 November 2008 the subject was discharged in franc abdominal recuperation. The subject was hospitalized for 3 days. Relevant test results included [laboratory results/hospital investigations]. The subject was treated with metronidazole, Ranitidine, amikacin and surgery. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 2/14/2018

VAERS ID: 334090 Before After
VAERS Form:1
Age:0.3
Gender:Female
Location:Foreign
Vaccinated:2008-10-21
Onset:2008-11-01
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, Blood creatinine normal, Blood glucose increased, Blood potassium normal, Blood sodium normal, Haematochezia, Haemoglobin normal, International normalised ratio normal, Intussusception, Irritability, Pallor, Prothrombin time normal, Surgery, Vomiting, White blood cell count, X-ray abnormal, Neutrophil percentage, Lymphocyte percentage, 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)? Yes
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, 02Nov2008, see text; Blood glucose, 02Nov2008, 117mg/dl; Creatinine, 02Nov2008, 0.4mg/dl; Hemoglobin, 02Nov2008, 10.8g/dl; International normalized ratio, 02Nov2008, 1.03UI; Leukocyte count NOS, 02Nov2008, 12500mm2; Lymphocytes, 02Nov2008, 36%; Neutrophils, 02Nov2008, 61%; Potassium, 02Nov2008, 4.4mEq/l; Prothrombin time, 02Nov2008, 11.7s; Sodium, 02Nov2008, 136mEq/l
CDC 'Split Type': B0549012A

Write-up: This case was reported by a physician in the frame of a PASS study and described the occurrence of intussusception in a 4-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). Previous and/or concurrent vaccination included live attenuated human rotavirus vaccine; GlaxoSmithKline; oral given on 21 August 2008. On 21 October 2008 the subject received 2nd dose of ROTARIX (oral). On 1 November 2008, 11 days after vaccination with ROTARIX, the subject experienced gastro alimentary vomiting, gastro biliar vomiting and bloody stools. On 02 November 2008 the subject was admitted to the emergency room with pallor, irritability, abdominal mass and rectal tact with fresh blood. Abdominal x-ray showed intestinal distention. Intussusception was suspected. The same day subject underwent a surgery showing evidence of ileocecocolic position. The event was resolved with taxis without complication. The subject''s clinical evolution was favorable. On 04 November 2008 the subject was discharged in franc abdominal recuperation. The subject was hospitalized for 3 days. Relevant test results included [laboratory results/hospital investigations]. The subject was treated with metronidazole, Ranitidine, amikacin and surgery. The physician considered the events were possibly related to vaccination with ROTARIX.


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