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This is VAERS ID 382967

History of Changes from the VAERS Wayback Machine

First Appeared on 4/7/2010

VAERS ID: 382967
VAERS Form:
Age:0.2
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:2008-12-12
Submitted:2010-03-18
Entered:2010-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal distension, Anaemia, Collapse of lung, Diarrhoea, Gastrointestinal disorder, Ileus, Intensive care, Intussusception, Laparotomy, Septic shock, X-ray abnormal, Abdominal X-ray, Transfusion

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? Yes, days: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, Dec2008, see text
CDC 'Split Type': B0639156A

Write-up: This case was reported by a physician and described the occurrence of invagination of intestine in a 2-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject did not have medical history. On an unspecified date, the subject received 1st dose of ROTARIX (1 ml, oral). On 12 December 2008, at an unspecified time after vaccination with ROTARIX, the subject experienced diarrhea and abdominal distention. On 19 December 2008, the subject presented abdominal distension and intestinal ileus. The subject was hospitalised and the physician considered the events were clinically significant (or requiring intervention). A plain abdominal x-Ray was performed and did not showed a visible intussusceptum of soft tissue mass. The exam showed fluid levels and dilated bowel loops. The demonstration of invagination of the intestine by air or liquid contrast enema was not done. The plain abdominal x-Ray showed non-specific abnormalities. The abdominal x-Ray showed bad intestinal distribution and intestinal distension, suspicious ileosileal intussusception which was confirmed and resolved by laparotomy and taxis on 21 December 2008. After the surgery, the subject presented pulmonary collapse, septic shock, anemia and need of transfusion. The subject required intensive unit care and was transfered to another hospital. The physician does not have complete dossier and does not have more data. At the time of reporting the outcome of the events was unspecified. It was not known if the subject survived.


Changed on 5/13/2013

VAERS ID: 382967 Before After
VAERS Form:
Age:0.2
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:2008-12-12
Submitted:2010-03-18
Entered:2010-03-18
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: Abdominal distension, Anaemia, Collapse of lung, Diarrhoea, Gastrointestinal disorder, Ileus, Intensive care, Intussusception, Laparotomy, Septic shock, X-ray abnormal, Abdominal X-ray, Transfusion

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? Yes, days: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, Dec2008, see text
CDC 'Split Type': B0639156A

Write-up: This case was reported by a physician and described the occurrence of invagination of intestine in a 2-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject did not have medical history. On an unspecified date, the subject received 1st dose of ROTARIX (1 ml, oral). On 12 December 2008, at an unspecified time after vaccination with ROTARIX, the subject experienced diarrhea and abdominal distention. On 19 December 2008, the subject presented abdominal distension and intestinal ileus. The subject was hospitalised and the physician considered the events were clinically significant (or requiring intervention). A plain abdominal x-Ray was performed and did not showed a visible intussusceptum of soft tissue mass. The exam showed fluid levels and dilated bowel loops. The demonstration of invagination of the intestine by air or liquid contrast enema was not done. The plain abdominal x-Ray showed non-specific abnormalities. The abdominal x-Ray showed bad intestinal distribution and intestinal distension, suspicious ileosileal intussusception which was confirmed and resolved by laparotomy and taxis on 21 December 2008. After the surgery, the subject presented pulmonary collapse, septic shock, anemia and need of transfusion. The subject required intensive unit care and was transfered to another hospital. The physician does not have complete dossier and does not have more data. At the time of reporting the outcome of the events was unspecified. It was not known if the subject survived.


Changed on 9/14/2017

VAERS ID: 382967 Before After
VAERS Form:(blank) 1
Age:0.2
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:2008-12-12
Submitted:2010-03-18
Entered:2010-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / - UNK - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal distension, Anaemia, Collapse of lung, Diarrhoea, Gastrointestinal disorder, Ileus, Intensive care, Intussusception, Laparotomy, Septic shock, X-ray abnormal, Abdominal X-ray, Transfusion

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? Yes, days: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, Dec2008, see text
CDC 'Split Type': B0639156A

Write-up: This case was reported by a physician and described the occurrence of invagination of intestine in a 2-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject did not have medical history. On an unspecified date, the subject received 1st dose of ROTARIX (1 ml, oral). On 12 December 2008, at an unspecified time after vaccination with ROTARIX, the subject experienced diarrhea and abdominal distention. On 19 December 2008, the subject presented abdominal distension and intestinal ileus. The subject was hospitalised and the physician considered the events were clinically significant (or requiring intervention). A plain abdominal x-Ray was performed and did not showed a visible intussusceptum of soft tissue mass. The exam showed fluid levels and dilated bowel loops. The demonstration of invagination of the intestine by air or liquid contrast enema was not done. The plain abdominal x-Ray showed non-specific abnormalities. The abdominal x-Ray showed bad intestinal distribution and intestinal distension, suspicious ileosileal intussusception which was confirmed and resolved by laparotomy and taxis on 21 December 2008. After the surgery, the subject presented pulmonary collapse, septic shock, anemia and need of transfusion. The subject required intensive unit care and was transfered to another hospital. The physician does not have complete dossier and does not have more data. At the time of reporting the outcome of the events was unspecified. It was not known if the subject survived.


Changed on 2/14/2018

VAERS ID: 382967 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:2008-12-12
Submitted:2010-03-18
Entered:2010-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal distension, Anaemia, Collapse of lung, Diarrhoea, Gastrointestinal disorder, Ileus, Intensive care, Intussusception, Laparotomy, Septic shock, X-ray abnormal, Abdominal X-ray, Transfusion

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? Yes, days: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, Dec2008, see text
CDC 'Split Type': B0639156A

Write-up: This case was reported by a physician and described the occurrence of invagination of intestine in a 2-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject did not have medical history. On an unspecified date, the subject received 1st dose of ROTARIX (1 ml, oral). On 12 December 2008, at an unspecified time after vaccination with ROTARIX, the subject experienced diarrhea and abdominal distention. On 19 December 2008, the subject presented abdominal distension and intestinal ileus. The subject was hospitalised and the physician considered the events were clinically significant (or requiring intervention). A plain abdominal x-Ray was performed and did not showed a visible intussusceptum of soft tissue mass. The exam showed fluid levels and dilated bowel loops. The demonstration of invagination of the intestine by air or liquid contrast enema was not done. The plain abdominal x-Ray showed non-specific abnormalities. The abdominal x-Ray showed bad intestinal distribution and intestinal distension, suspicious ileosileal intussusception which was confirmed and resolved by laparotomy and taxis on 21 December 2008. After the surgery, the subject presented pulmonary collapse, septic shock, anemia and need of transfusion. The subject required intensive unit care and was transfered to another hospital. The physician does not have complete dossier and does not have more data. At the time of reporting the outcome of the events was unspecified. It was not known if the subject survived.


Changed on 6/14/2018

VAERS ID: 382967 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:2008-12-12
Submitted:2010-03-18
Entered:2010-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal distension, Anaemia, Collapse of lung, Diarrhoea, Gastrointestinal disorder, Ileus, Intensive care, Intussusception, Laparotomy, Septic shock, X-ray abnormal, Abdominal X-ray, Transfusion

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? Yes, days: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, Dec2008, see text
CDC 'Split Type': B0639156A

Write-up: This case was reported by a physician and described the occurrence of invagination of intestine in a 2-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject did not have medical history. On an unspecified date, the subject received 1st dose of ROTARIX (1 ml, oral). On 12 December 2008, at an unspecified time after vaccination with ROTARIX, the subject experienced diarrhea and abdominal distention. On 19 December 2008, the subject presented abdominal distension and intestinal ileus. The subject was hospitalised and the physician considered the events were clinically significant (or requiring intervention). A plain abdominal x-Ray was performed and did not showed a visible intussusceptum of soft tissue mass. The exam showed fluid levels and dilated bowel loops. The demonstration of invagination of the intestine by air or liquid contrast enema was not done. The plain abdominal x-Ray showed non-specific abnormalities. The abdominal x-Ray showed bad intestinal distribution and intestinal distension, suspicious ileosileal intussusception which was confirmed and resolved by laparotomy and taxis on 21 December 2008. After the surgery, the subject presented pulmonary collapse, septic shock, anemia and need of transfusion. The subject required intensive unit care and was transfered to another hospital. The physician does not have complete dossier and does not have more data. At the time of reporting the outcome of the events was unspecified. It was not known if the subject survived.


Changed on 8/14/2018

VAERS ID: 382967 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:2008-12-12
Submitted:2010-03-18
Entered:2010-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal distension, Anaemia, Collapse of lung, Diarrhoea, Gastrointestinal disorder, Ileus, Intensive care, Intussusception, Laparotomy, Septic shock, X-ray abnormal, Abdominal X-ray, Transfusion

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? Yes, days: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, Dec2008, see text
CDC 'Split Type': B0639156A

Write-up: This case was reported by a physician and described the occurrence of invagination of intestine in a 2-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject did not have medical history. On an unspecified date, the subject received 1st dose of ROTARIX (1 ml, oral). On 12 December 2008, at an unspecified time after vaccination with ROTARIX, the subject experienced diarrhea and abdominal distention. On 19 December 2008, the subject presented abdominal distension and intestinal ileus. The subject was hospitalised and the physician considered the events were clinically significant (or requiring intervention). A plain abdominal x-Ray was performed and did not showed a visible intussusceptum of soft tissue mass. The exam showed fluid levels and dilated bowel loops. The demonstration of invagination of the intestine by air or liquid contrast enema was not done. The plain abdominal x-Ray showed non-specific abnormalities. The abdominal x-Ray showed bad intestinal distribution and intestinal distension, suspicious ileosileal intussusception which was confirmed and resolved by laparotomy and taxis on 21 December 2008. After the surgery, the subject presented pulmonary collapse, septic shock, anemia and need of transfusion. The subject required intensive unit care and was transfered to another hospital. The physician does not have complete dossier and does not have more data. At the time of reporting the outcome of the events was unspecified. It was not known if the subject survived.


Changed on 9/14/2018

VAERS ID: 382967 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:2008-12-12
Submitted:2010-03-18
Entered:2010-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal distension, Anaemia, Collapse of lung, Diarrhoea, Gastrointestinal disorder, Ileus, Intensive care, Intussusception, Laparotomy, Septic shock, X-ray abnormal, Abdominal X-ray, Transfusion

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? Yes, days: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, Dec2008, see text
CDC 'Split Type': B0639156A

Write-up: This case was reported by a physician and described the occurrence of invagination of intestine in a 2-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject did not have medical history. On an unspecified date, the subject received 1st dose of ROTARIX (1 ml, oral). On 12 December 2008, at an unspecified time after vaccination with ROTARIX, the subject experienced diarrhea and abdominal distention. On 19 December 2008, the subject presented abdominal distension and intestinal ileus. The subject was hospitalised and the physician considered the events were clinically significant (or requiring intervention). A plain abdominal x-Ray was performed and did not showed a visible intussusceptum of soft tissue mass. The exam showed fluid levels and dilated bowel loops. The demonstration of invagination of the intestine by air or liquid contrast enema was not done. The plain abdominal x-Ray showed non-specific abnormalities. The abdominal x-Ray showed bad intestinal distribution and intestinal distension, suspicious ileosileal intussusception which was confirmed and resolved by laparotomy and taxis on 21 December 2008. After the surgery, the subject presented pulmonary collapse, septic shock, anemia and need of transfusion. The subject required intensive unit care and was transfered to another hospital. The physician does not have complete dossier and does not have more data. At the time of reporting the outcome of the events was unspecified. It was not known if the subject survived.


Changed on 10/14/2018

VAERS ID: 382967 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:2008-12-12
Submitted:2010-03-18
Entered:2010-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal distension, Anaemia, Collapse of lung, Diarrhoea, Gastrointestinal disorder, Ileus, Intensive care, Intussusception, Laparotomy, Septic shock, X-ray abnormal, Abdominal X-ray, Transfusion

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? Yes, days: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray, Dec2008, see text
CDC 'Split Type': B0639156A

Write-up: This case was reported by a physician and described the occurrence of invagination of intestine in a 2-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject did not have medical history. On an unspecified date, the subject received 1st dose of ROTARIX (1 ml, oral). On 12 December 2008, at an unspecified time after vaccination with ROTARIX, the subject experienced diarrhea and abdominal distention. On 19 December 2008, the subject presented abdominal distension and intestinal ileus. The subject was hospitalised and the physician considered the events were clinically significant (or requiring intervention). A plain abdominal x-Ray was performed and did not showed a visible intussusceptum of soft tissue mass. The exam showed fluid levels and dilated bowel loops. The demonstration of invagination of the intestine by air or liquid contrast enema was not done. The plain abdominal x-Ray showed non-specific abnormalities. The abdominal x-Ray showed bad intestinal distribution and intestinal distension, suspicious ileosileal intussusception which was confirmed and resolved by laparotomy and taxis on 21 December 2008. After the surgery, the subject presented pulmonary collapse, septic shock, anemia and need of transfusion. The subject required intensive unit care and was transfered to another hospital. The physician does not have complete dossier and does not have more data. At the time of reporting the outcome of the events was unspecified. It was not known if the subject survived.

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