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This is VAERS ID 335414

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 335414
VAERS Form:
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-11-29
Onset:2008-12-06
Submitted:2008-12-16
Entered:2008-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 0 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal mass, Colostomy, Haematochezia, Intensive care, Intussusception, Laparoscopy abnormal, Surgery, Intestinal resection

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
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: Laparoscopy, 08Dec2008, see text
CDC 'Split Type': B0549988A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 4-month-old male subject who was vaccinated with ROTARIX, (GlaxoSmithKline). On 29 November 2008, the subject received 1st dose of ROTARIX (oral). Lot number not provided. On 6 December 2008, 7 days after vaccination with ROTARIX, the subject started with blood streaked stools progressing to bloody stools. The patient was admitted on 6 December at ER. On 8 December 2008, exploratory laparoscopy was performed. Intussusception and abdominal mass were diagnosed. Intestine resection and colostomy were done. The subject was hospitalised and the physician considered the events were life threatening. At the time of reporting the events were improved, the subject was still at ICU. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 5/13/2013

VAERS ID: 335414 Before After
VAERS Form:
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-11-29
Onset:2008-12-06
Submitted:2008-12-16
Entered:2008-12-16
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 mass, Colostomy, Haematochezia, Intensive care, Intussusception, Laparoscopy abnormal, Surgery, Intestinal resection

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
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: Laparoscopy, 08Dec2008, see text
CDC 'Split Type': B0549988A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 4-month-old male subject who was vaccinated with ROTARIX, (GlaxoSmithKline). On 29 November 2008, the subject received 1st dose of ROTARIX (oral). Lot number not provided. On 6 December 2008, 7 days after vaccination with ROTARIX, the subject started with blood streaked stools progressing to bloody stools. The patient was admitted on 6 December at ER. On 8 December 2008, exploratory laparoscopy was performed. Intussusception and abdominal mass were diagnosed. Intestine resection and colostomy were done. The subject was hospitalised and the physician considered the events were life threatening. At the time of reporting the events were improved, the subject was still at ICU. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 9/14/2017

VAERS ID: 335414 Before After
VAERS Form:(blank) 1
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-11-29
Onset:2008-12-06
Submitted:2008-12-16
Entered:2008-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 0 1 - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal mass, Colostomy, Haematochezia, Intensive care, Intussusception, Laparoscopy abnormal, Surgery, Intestinal resection

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
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: Laparoscopy, 08Dec2008, see text
CDC 'Split Type': B0549988A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 4-month-old male subject who was vaccinated with ROTARIX, (GlaxoSmithKline). On 29 November 2008, the subject received 1st dose of ROTARIX (oral). Lot number not provided. On 6 December 2008, 7 days after vaccination with ROTARIX, the subject started with blood streaked stools progressing to bloody stools. The patient was admitted on 6 December at ER. On 8 December 2008, exploratory laparoscopy was performed. Intussusception and abdominal mass were diagnosed. Intestine resection and colostomy were done. The subject was hospitalised and the physician considered the events were life threatening. At the time of reporting the events were improved, the subject was still at ICU. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 2/14/2018

VAERS ID: 335414 Before After
VAERS Form:1
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-11-29
Onset:2008-12-06
Submitted:2008-12-16
Entered:2008-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal mass, Colostomy, Haematochezia, Intensive care, Intussusception, Laparoscopy abnormal, Surgery, Intestinal resection

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
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: Laparoscopy, 08Dec2008, see text
CDC 'Split Type': B0549988A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 4-month-old male subject who was vaccinated with ROTARIX, (GlaxoSmithKline). On 29 November 2008, the subject received 1st dose of ROTARIX (oral). Lot number not provided. On 6 December 2008, 7 days after vaccination with ROTARIX, the subject started with blood streaked stools progressing to bloody stools. The patient was admitted on 6 December at ER. On 8 December 2008, exploratory laparoscopy was performed. Intussusception and abdominal mass were diagnosed. Intestine resection and colostomy were done. The subject was hospitalised and the physician considered the events were life threatening. At the time of reporting the events were improved, the subject was still at ICU. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 6/14/2018

VAERS ID: 335414 Before After
VAERS Form:1
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-11-29
Onset:2008-12-06
Submitted:2008-12-16
Entered:2008-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal mass, Colostomy, Haematochezia, Intensive care, Intussusception, Laparoscopy abnormal, Surgery, Intestinal resection

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
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: Laparoscopy, 08Dec2008, see text
CDC 'Split Type': B0549988A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 4-month-old male subject who was vaccinated with ROTARIX, (GlaxoSmithKline). On 29 November 2008, the subject received 1st dose of ROTARIX (oral). Lot number not provided. On 6 December 2008, 7 days after vaccination with ROTARIX, the subject started with blood streaked stools progressing to bloody stools. The patient was admitted on 6 December at ER. On 8 December 2008, exploratory laparoscopy was performed. Intussusception and abdominal mass were diagnosed. Intestine resection and colostomy were done. The subject was hospitalised and the physician considered the events were life threatening. At the time of reporting the events were improved, the subject was still at ICU. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 8/14/2018

VAERS ID: 335414 Before After
VAERS Form:1
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-11-29
Onset:2008-12-06
Submitted:2008-12-16
Entered:2008-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal mass, Colostomy, Haematochezia, Intensive care, Intussusception, Laparoscopy abnormal, Surgery, Intestinal resection

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
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: Laparoscopy, 08Dec2008, see text
CDC 'Split Type': B0549988A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 4-month-old male subject who was vaccinated with ROTARIX, (GlaxoSmithKline). On 29 November 2008, the subject received 1st dose of ROTARIX (oral). Lot number not provided. On 6 December 2008, 7 days after vaccination with ROTARIX, the subject started with blood streaked stools progressing to bloody stools. The patient was admitted on 6 December at ER. On 8 December 2008, exploratory laparoscopy was performed. Intussusception and abdominal mass were diagnosed. Intestine resection and colostomy were done. The subject was hospitalised and the physician considered the events were life threatening. At the time of reporting the events were improved, the subject was still at ICU. The physician considered the events were possibly related to vaccination with ROTARIX.


Changed on 9/14/2018

VAERS ID: 335414 Before After
VAERS Form:1
Age:0.3
Gender:Male
Location:Foreign
Vaccinated:2008-11-29
Onset:2008-12-06
Submitted:2008-12-16
Entered:2008-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal mass, Colostomy, Haematochezia, Intensive care, Intussusception, Laparoscopy abnormal, Surgery, Intestinal resection

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
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: Laparoscopy, 08Dec2008, see text
CDC 'Split Type': B0549988A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a 4-month-old male subject who was vaccinated with ROTARIX, (GlaxoSmithKline). On 29 November 2008, the subject received 1st dose of ROTARIX (oral). Lot number not provided. On 6 December 2008, 7 days after vaccination with ROTARIX, the subject started with blood streaked stools progressing to bloody stools. The patient was admitted on 6 December at ER. On 8 December 2008, exploratory laparoscopy was performed. Intussusception and abdominal mass were diagnosed. Intestine resection and colostomy were done. The subject was hospitalised and the physician considered the events were life threatening. At the time of reporting the events were improved, the subject was still at ICU. The physician considered the events were possibly related to vaccination with ROTARIX.

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