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This is VAERS ID 380532

History of Changes from the VAERS Wayback Machine

First Appeared on 3/2/2010

VAERS ID: 380532
VAERS Form:
Age:
Sex:Unknown
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2010-02-16
Entered:2010-02-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - - / PO

Administered by: Other      Purchased by: Other
Symptoms: Haematochezia, Intussusception, Pneumonia, Surgery

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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': B0631757A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a baby subject and gender unknown who was vaccinated with ROTARIX (Glaxosmithkline). On an unspecified date, at 3 and 4 months old, the subject received 2nd dose of ROTARIX (oral). At an unspecified time after vaccination with ROTARIX, the subject experienced intussusception, pneumonia and bloody stools. The subject was hospitalised due to pneumonia. During first day of hospitalization, the subject developed bloody stools and was operated for intussusception on 3rd day of hospitalization. This case was assessed as medically serious by GSK. At the time of reporting the outcome of the events was unspecified. Further information has been requested.


Changed on 5/13/2013

VAERS ID: 380532 Before After
VAERS Form:
Age:
Sex:Unknown
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2010-02-16
Entered:2010-02-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - - / PO
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - - / PO

Administered by: Other      Purchased by: Other
Symptoms: Haematochezia, Intussusception, Pneumonia, Surgery

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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': B0631757A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a baby subject and gender unknown who was vaccinated with ROTARIX (Glaxosmithkline). On an unspecified date, at 3 and 4 months old, the subject received 2nd dose of ROTARIX (oral). At an unspecified time after vaccination with ROTARIX, the subject experienced intussusception, pneumonia and bloody stools. The subject was hospitalised due to pneumonia. During first day of hospitalization, the subject developed bloody stools and was operated for intussusception on 3rd day of hospitalization. This case was assessed as medically serious by GSK. At the time of reporting the outcome of the events was unspecified. Further information has been requested.


Changed on 9/14/2017

VAERS ID: 380532 Before After
VAERS Form:(blank) 1
Age:
Sex:Unknown
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2010-02-16
Entered:2010-02-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - UNK - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Haematochezia, Intussusception, Pneumonia, Surgery

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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': B0631757A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a baby subject and gender unknown who was vaccinated with ROTARIX (Glaxosmithkline). On an unspecified date, at 3 and 4 months old, the subject received 2nd dose of ROTARIX (oral). At an unspecified time after vaccination with ROTARIX, the subject experienced intussusception, pneumonia and bloody stools. The subject was hospitalised due to pneumonia. During first day of hospitalization, the subject developed bloody stools and was operated for intussusception on 3rd day of hospitalization. This case was assessed as medically serious by GSK. At the time of reporting the outcome of the events was unspecified. Further information has been requested.


Changed on 2/14/2018

VAERS ID: 380532 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2010-02-16
Entered:2010-02-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Haematochezia, Intussusception, Pneumonia, Surgery

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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': B0631757A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a baby subject and gender unknown who was vaccinated with ROTARIX (Glaxosmithkline). On an unspecified date, at 3 and 4 months old, the subject received 2nd dose of ROTARIX (oral). At an unspecified time after vaccination with ROTARIX, the subject experienced intussusception, pneumonia and bloody stools. The subject was hospitalised due to pneumonia. During first day of hospitalization, the subject developed bloody stools and was operated for intussusception on 3rd day of hospitalization. This case was assessed as medically serious by GSK. At the time of reporting the outcome of the events was unspecified. Further information has been requested.


Changed on 6/14/2018

VAERS ID: 380532 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2010-02-16
Entered:2010-02-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Haematochezia, Intussusception, Pneumonia, Surgery

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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': B0631757A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a baby subject and gender unknown who was vaccinated with ROTARIX (Glaxosmithkline). On an unspecified date, at 3 and 4 months old, the subject received 2nd dose of ROTARIX (oral). At an unspecified time after vaccination with ROTARIX, the subject experienced intussusception, pneumonia and bloody stools. The subject was hospitalised due to pneumonia. During first day of hospitalization, the subject developed bloody stools and was operated for intussusception on 3rd day of hospitalization. This case was assessed as medically serious by GSK. At the time of reporting the outcome of the events was unspecified. Further information has been requested.


Changed on 8/14/2018

VAERS ID: 380532 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2010-02-16
Entered:2010-02-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Haematochezia, Intussusception, Pneumonia, Surgery

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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': B0631757A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a baby subject and gender unknown who was vaccinated with ROTARIX (Glaxosmithkline). On an unspecified date, at 3 and 4 months old, the subject received 2nd dose of ROTARIX (oral). At an unspecified time after vaccination with ROTARIX, the subject experienced intussusception, pneumonia and bloody stools. The subject was hospitalised due to pneumonia. During first day of hospitalization, the subject developed bloody stools and was operated for intussusception on 3rd day of hospitalization. This case was assessed as medically serious by GSK. At the time of reporting the outcome of the events was unspecified. Further information has been requested.


Changed on 9/14/2018

VAERS ID: 380532 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2010-02-16
Entered:2010-02-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Haematochezia, Intussusception, Pneumonia, Surgery

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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': B0631757A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a baby subject and gender unknown who was vaccinated with ROTARIX (Glaxosmithkline). On an unspecified date, at 3 and 4 months old, the subject received 2nd dose of ROTARIX (oral). At an unspecified time after vaccination with ROTARIX, the subject experienced intussusception, pneumonia and bloody stools. The subject was hospitalised due to pneumonia. During first day of hospitalization, the subject developed bloody stools and was operated for intussusception on 3rd day of hospitalization. This case was assessed as medically serious by GSK. At the time of reporting the outcome of the events was unspecified. Further information has been requested.


Changed on 10/14/2018

VAERS ID: 380532 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2010-02-16
Entered:2010-02-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Haematochezia, Intussusception, Pneumonia, Surgery

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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': B0631757A

Write-up: This case was reported by a physician and described the occurrence of intussusception in a baby subject and gender unknown who was vaccinated with ROTARIX (Glaxosmithkline). On an unspecified date, at 3 and 4 months old, the subject received 2nd dose of ROTARIX (oral). At an unspecified time after vaccination with ROTARIX, the subject experienced intussusception, pneumonia and bloody stools. The subject was hospitalised due to pneumonia. During first day of hospitalization, the subject developed bloody stools and was operated for intussusception on 3rd day of hospitalization. This case was assessed as medically serious by GSK. At the time of reporting the outcome of the events was unspecified. Further information has been requested.

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