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This is VAERS ID 334096

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 334096
VAERS Form:
Age:0.2
Gender:Male
Location:Foreign
Vaccinated:2008-08-20
Onset:2008-10-05
Submitted:2008-12-05
Entered:2008-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 0 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Decreased activity, Haematochezia, Intussusception, Irritability, Mucous stools, Pallor, Surgery, Vomiting, Gastrointestinal sounds abnormal

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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0548917A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 3-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). On 20 August subject received 1st dose of ROTARIX (oral). On 5 October 2008, 46 days after vaccination with ROTARIX, the subject experienced irritability, gastro alimentary vomiting. He received ambulatory treatment with erythromycin and acetaminophen without improvement. He had bloody stools (3 episodes), hypoactive and pallor. The same day the subject was hospitalized. Physical examination showed hypo activity, pallor, and abdominal pain on palpation, decreased bowel sounds and current jelly stools. The diagnosis of intussusception was made by clinical feature. The subject underwent a surgery the same day. Ileocecocolic intussusception was found and reduced by taxis without complications. On 09 October 2008 the subject was discharged in good clinical conditions. The subject was treated with acetaminophen, Ranitidine and metronidazole. The physician considered the events were unrelated to vaccination with ROTARIX.


Changed on 5/13/2013

VAERS ID: 334096 Before After
VAERS Form:
Age:0.2
Gender:Male
Location:Foreign
Vaccinated:2008-08-20
Onset:2008-10-05
Submitted:2008-12-05
Entered:2008-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 0 - / PO
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 0 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Decreased activity, Haematochezia, Intussusception, Irritability, Mucous stools, Pallor, Surgery, Vomiting, Gastrointestinal sounds abnormal

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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0548917A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 3-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). On 20 August subject received 1st dose of ROTARIX (oral). On 5 October 2008, 46 days after vaccination with ROTARIX, the subject experienced irritability, gastro alimentary vomiting. He received ambulatory treatment with erythromycin and acetaminophen without improvement. He had bloody stools (3 episodes), hypoactive and pallor. The same day the subject was hospitalized. Physical examination showed hypo activity, pallor, and abdominal pain on palpation, decreased bowel sounds and current jelly stools. The diagnosis of intussusception was made by clinical feature. The subject underwent a surgery the same day. Ileocecocolic intussusception was found and reduced by taxis without complications. On 09 October 2008 the subject was discharged in good clinical conditions. The subject was treated with acetaminophen, Ranitidine and metronidazole. The physician considered the events were unrelated to vaccination with ROTARIX.


Changed on 9/14/2017

VAERS ID: 334096 Before After
VAERS Form:(blank) 1
Age:0.2
Gender:Male
Location:Foreign
Vaccinated:2008-08-20
Onset:2008-10-05
Submitted:2008-12-05
Entered:2008-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 0 1 - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Decreased activity, Haematochezia, Intussusception, Irritability, Mucous stools, Pallor, Surgery, Vomiting, Gastrointestinal sounds abnormal

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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0548917A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 3-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). On 20 August subject received 1st dose of ROTARIX (oral). On 5 October 2008, 46 days after vaccination with ROTARIX, the subject experienced irritability, gastro alimentary vomiting. He received ambulatory treatment with erythromycin and acetaminophen without improvement. He had bloody stools (3 episodes), hypoactive and pallor. The same day the subject was hospitalized. Physical examination showed hypo activity, pallor, and abdominal pain on palpation, decreased bowel sounds and current jelly stools. The diagnosis of intussusception was made by clinical feature. The subject underwent a surgery the same day. Ileocecocolic intussusception was found and reduced by taxis without complications. On 09 October 2008 the subject was discharged in good clinical conditions. The subject was treated with acetaminophen, Ranitidine and metronidazole. The physician considered the events were unrelated to vaccination with ROTARIX.


Changed on 2/14/2018

VAERS ID: 334096 Before After
VAERS Form:1
Age:0.2
Gender:Male
Location:Foreign
Vaccinated:2008-08-20
Onset:2008-10-05
Submitted:2008-12-05
Entered:2008-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Decreased activity, Haematochezia, Intussusception, Irritability, Mucous stools, Pallor, Surgery, Vomiting, Gastrointestinal sounds abnormal

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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0548917A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 3-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). On 20 August subject received 1st dose of ROTARIX (oral). On 5 October 2008, 46 days after vaccination with ROTARIX, the subject experienced irritability, gastro alimentary vomiting. He received ambulatory treatment with erythromycin and acetaminophen without improvement. He had bloody stools (3 episodes), hypoactive and pallor. The same day the subject was hospitalized. Physical examination showed hypo activity, pallor, and abdominal pain on palpation, decreased bowel sounds and current jelly stools. The diagnosis of intussusception was made by clinical feature. The subject underwent a surgery the same day. Ileocecocolic intussusception was found and reduced by taxis without complications. On 09 October 2008 the subject was discharged in good clinical conditions. The subject was treated with acetaminophen, Ranitidine and metronidazole. The physician considered the events were unrelated to vaccination with ROTARIX.


Changed on 6/14/2018

VAERS ID: 334096 Before After
VAERS Form:1
Age:0.2
Gender:Male
Location:Foreign
Vaccinated:2008-08-20
Onset:2008-10-05
Submitted:2008-12-05
Entered:2008-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Decreased activity, Haematochezia, Intussusception, Irritability, Mucous stools, Pallor, Surgery, Vomiting, Gastrointestinal sounds abnormal

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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0548917A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 3-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). On 20 August subject received 1st dose of ROTARIX (oral). On 5 October 2008, 46 days after vaccination with ROTARIX, the subject experienced irritability, gastro alimentary vomiting. He received ambulatory treatment with erythromycin and acetaminophen without improvement. He had bloody stools (3 episodes), hypoactive and pallor. The same day the subject was hospitalized. Physical examination showed hypo activity, pallor, and abdominal pain on palpation, decreased bowel sounds and current jelly stools. The diagnosis of intussusception was made by clinical feature. The subject underwent a surgery the same day. Ileocecocolic intussusception was found and reduced by taxis without complications. On 09 October 2008 the subject was discharged in good clinical conditions. The subject was treated with acetaminophen, Ranitidine and metronidazole. The physician considered the events were unrelated to vaccination with ROTARIX.


Changed on 8/14/2018

VAERS ID: 334096 Before After
VAERS Form:1
Age:0.2
Gender:Male
Location:Foreign
Vaccinated:2008-08-20
Onset:2008-10-05
Submitted:2008-12-05
Entered:2008-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Decreased activity, Haematochezia, Intussusception, Irritability, Mucous stools, Pallor, Surgery, Vomiting, Gastrointestinal sounds abnormal

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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0548917A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 3-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). On 20 August subject received 1st dose of ROTARIX (oral). On 5 October 2008, 46 days after vaccination with ROTARIX, the subject experienced irritability, gastro alimentary vomiting. He received ambulatory treatment with erythromycin and acetaminophen without improvement. He had bloody stools (3 episodes), hypoactive and pallor. The same day the subject was hospitalized. Physical examination showed hypo activity, pallor, and abdominal pain on palpation, decreased bowel sounds and current jelly stools. The diagnosis of intussusception was made by clinical feature. The subject underwent a surgery the same day. Ileocecocolic intussusception was found and reduced by taxis without complications. On 09 October 2008 the subject was discharged in good clinical conditions. The subject was treated with acetaminophen, Ranitidine and metronidazole. The physician considered the events were unrelated to vaccination with ROTARIX.


Changed on 9/14/2018

VAERS ID: 334096 Before After
VAERS Form:1
Age:0.2
Gender:Male
Location:Foreign
Vaccinated:2008-08-20
Onset:2008-10-05
Submitted:2008-12-05
Entered:2008-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Decreased activity, Haematochezia, Intussusception, Irritability, Mucous stools, Pallor, Surgery, Vomiting, Gastrointestinal sounds abnormal

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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0548917A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 3-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). On 20 August subject received 1st dose of ROTARIX (oral). On 5 October 2008, 46 days after vaccination with ROTARIX, the subject experienced irritability, gastro alimentary vomiting. He received ambulatory treatment with erythromycin and acetaminophen without improvement. He had bloody stools (3 episodes), hypoactive and pallor. The same day the subject was hospitalized. Physical examination showed hypo activity, pallor, and abdominal pain on palpation, decreased bowel sounds and current jelly stools. The diagnosis of intussusception was made by clinical feature. The subject underwent a surgery the same day. Ileocecocolic intussusception was found and reduced by taxis without complications. On 09 October 2008 the subject was discharged in good clinical conditions. The subject was treated with acetaminophen, Ranitidine and metronidazole. The physician considered the events were unrelated to vaccination with ROTARIX.


Changed on 10/14/2018

VAERS ID: 334096 Before After
VAERS Form:1
Age:0.2
Gender:Male
Location:Foreign
Vaccinated:2008-08-20
Onset:2008-10-05
Submitted:2008-12-05
Entered:2008-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Decreased activity, Haematochezia, Intussusception, Irritability, Mucous stools, Pallor, Surgery, Vomiting, Gastrointestinal sounds abnormal

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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0548917A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of intussusception in a 3-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). On 20 August subject received 1st dose of ROTARIX (oral). On 5 October 2008, 46 days after vaccination with ROTARIX, the subject experienced irritability, gastro alimentary vomiting. He received ambulatory treatment with erythromycin and acetaminophen without improvement. He had bloody stools (3 episodes), hypoactive and pallor. The same day the subject was hospitalized. Physical examination showed hypo activity, pallor, and abdominal pain on palpation, decreased bowel sounds and current jelly stools. The diagnosis of intussusception was made by clinical feature. The subject underwent a surgery the same day. Ileocecocolic intussusception was found and reduced by taxis without complications. On 09 October 2008 the subject was discharged in good clinical conditions. The subject was treated with acetaminophen, Ranitidine and metronidazole. The physician considered the events were unrelated to vaccination with ROTARIX.

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