National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 336189

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 336189
VAERS Form:
Age:0.2
Sex:Male
Location:Foreign
Vaccinated:2008-01-01
Onset:2008-11-28
Submitted:2008-12-29
Entered:2008-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Barium enema, Intussusception, Enema administration

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? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0551651A

Write-up: This case was reported by a physician via a GSK representative and described the occurrence of invagination of intestine in a 13 month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). Medical condition was unspecified. First dose of ROTARIX was given in December 2007. In January 2008, the subject received a 2nd dose of ROTARIX (oral, batch not available). On 28 November 2008, 10 months after the second vaccination with ROTARIX, the subject developed invagination of intestine, confirmed by unspecified investigations. The subject was treated with barium salt and event resolved without sequelae. This case was assessed as medically serious by GSK. The physician considered the event was unrelated to vaccination with ROTARIX.


Changed on 5/13/2013

VAERS ID: 336189 Before After
VAERS Form:
Age:0.2
Sex:Male
Location:Foreign
Vaccinated:2008-01-01
Onset:2008-11-28
Submitted:2008-12-29
Entered:2008-12-29
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: Barium enema, Intussusception, Enema administration

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? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0551651A

Write-up: This case was reported by a physician via a GSK representative and described the occurrence of invagination of intestine in a 13 month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). Medical condition was unspecified. First dose of ROTARIX was given in December 2007. In January 2008, the subject received a 2nd dose of ROTARIX (oral, batch not available). On 28 November 2008, 10 months after the second vaccination with ROTARIX, the subject developed invagination of intestine, confirmed by unspecified investigations. The subject was treated with barium salt and event resolved without sequelae. This case was assessed as medically serious by GSK. The physician considered the event was unrelated to vaccination with ROTARIX.


Changed on 9/14/2017

VAERS ID: 336189 Before After
VAERS Form:(blank) 1
Age:0.2
Sex:Male
Location:Foreign
Vaccinated:2008-01-01
Onset:2008-11-28
Submitted:2008-12-29
Entered:2008-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 2 - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Barium enema, Intussusception, Enema administration

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? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0551651A

Write-up: This case was reported by a physician via a GSK representative and described the occurrence of invagination of intestine in a 13 month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). Medical condition was unspecified. First dose of ROTARIX was given in December 2007. In January 2008, the subject received a 2nd dose of ROTARIX (oral, batch not available). On 28 November 2008, 10 months after the second vaccination with ROTARIX, the subject developed invagination of intestine, confirmed by unspecified investigations. The subject was treated with barium salt and event resolved without sequelae. This case was assessed as medically serious by GSK. The physician considered the event was unrelated to vaccination with ROTARIX.


Changed on 2/14/2018

VAERS ID: 336189 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Foreign
Vaccinated:2008-01-01
Onset:2008-11-28
Submitted:2008-12-29
Entered:2008-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 2 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Barium enema, Intussusception, Enema administration

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? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0551651A

Write-up: This case was reported by a physician via a GSK representative and described the occurrence of invagination of intestine in a 13 month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). Medical condition was unspecified. First dose of ROTARIX was given in December 2007. In January 2008, the subject received a 2nd dose of ROTARIX (oral, batch not available). On 28 November 2008, 10 months after the second vaccination with ROTARIX, the subject developed invagination of intestine, confirmed by unspecified investigations. The subject was treated with barium salt and event resolved without sequelae. This case was assessed as medically serious by GSK. The physician considered the event was unrelated to vaccination with ROTARIX.


Changed on 6/14/2018

VAERS ID: 336189 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Foreign
Vaccinated:2008-01-01
Onset:2008-11-28
Submitted:2008-12-29
Entered:2008-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 2 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Barium enema, Intussusception, Enema administration

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? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0551651A

Write-up: This case was reported by a physician via a GSK representative and described the occurrence of invagination of intestine in a 13 month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). Medical condition was unspecified. First dose of ROTARIX was given in December 2007. In January 2008, the subject received a 2nd dose of ROTARIX (oral, batch not available). On 28 November 2008, 10 months after the second vaccination with ROTARIX, the subject developed invagination of intestine, confirmed by unspecified investigations. The subject was treated with barium salt and event resolved without sequelae. This case was assessed as medically serious by GSK. The physician considered the event was unrelated to vaccination with ROTARIX.


Changed on 8/14/2018

VAERS ID: 336189 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Foreign
Vaccinated:2008-01-01
Onset:2008-11-28
Submitted:2008-12-29
Entered:2008-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 2 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Barium enema, Intussusception, Enema administration

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? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0551651A

Write-up: This case was reported by a physician via a GSK representative and described the occurrence of invagination of intestine in a 13 month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). Medical condition was unspecified. First dose of ROTARIX was given in December 2007. In January 2008, the subject received a 2nd dose of ROTARIX (oral, batch not available). On 28 November 2008, 10 months after the second vaccination with ROTARIX, the subject developed invagination of intestine, confirmed by unspecified investigations. The subject was treated with barium salt and event resolved without sequelae. This case was assessed as medically serious by GSK. The physician considered the event was unrelated to vaccination with ROTARIX.


Changed on 9/14/2018

VAERS ID: 336189 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Foreign
Vaccinated:2008-01-01
Onset:2008-11-28
Submitted:2008-12-29
Entered:2008-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 2 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Barium enema, Intussusception, Enema administration

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? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0551651A

Write-up: This case was reported by a physician via a GSK representative and described the occurrence of invagination of intestine in a 13 month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). Medical condition was unspecified. First dose of ROTARIX was given in December 2007. In January 2008, the subject received a 2nd dose of ROTARIX (oral, batch not available). On 28 November 2008, 10 months after the second vaccination with ROTARIX, the subject developed invagination of intestine, confirmed by unspecified investigations. The subject was treated with barium salt and event resolved without sequelae. This case was assessed as medically serious by GSK. The physician considered the event was unrelated to vaccination with ROTARIX.


Changed on 10/14/2018

VAERS ID: 336189 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:Foreign
Vaccinated:2008-01-01
Onset:2008-11-28
Submitted:2008-12-29
Entered:2008-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 2 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Barium enema, Intussusception, Enema administration

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? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0551651A

Write-up: This case was reported by a physician via a GSK representative and described the occurrence of invagination of intestine in a 13 month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). Medical condition was unspecified. First dose of ROTARIX was given in December 2007. In January 2008, the subject received a 2nd dose of ROTARIX (oral, batch not available). On 28 November 2008, 10 months after the second vaccination with ROTARIX, the subject developed invagination of intestine, confirmed by unspecified investigations. The subject was treated with barium salt and event resolved without sequelae. This case was assessed as medically serious by GSK. The physician considered the event was unrelated to vaccination with ROTARIX.

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=336189&WAYBACKHISTORY=ON


Copyright © 2019 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166