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This is VAERS ID 384490

History of Changes from the VAERS Wayback Machine

First Appeared on 4/7/2010

VAERS ID: 384490
VAERS Form:
Age:0.3
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2010-04-07
Entered:2010-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 0 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Crying, Diet refusal, Intussusception, X-ray abnormal, Enema administration, Ultrasound scan 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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ultrasound scan, intussusception; X-ray, intussusception
CDC 'Split Type': B0645429A

Write-up: This case was reported by a foreign regulatory authority (AM20090420) and described the occurrence of intussusception of intestine in a 3-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). Medical conditions and concurrent medications were unspecified. The subject weighted 5.8 kg and measured 57 cm. On an unspecified date, the subject received a 1st dose of ROTARIX (batch unknown, oral). Three days after vaccination with ROTARIX, the subject was hospitalized for crying and refusal to eat. Ultrasound scan and X-ray showed intussusception of intestine, reduced by hydrosoluble enema. All the events resolved. According to the foreign method of assessment, the relationship between vaccination with ROTARIX and the reported events was dubious.


Changed on 5/13/2013

VAERS ID: 384490 Before After
VAERS Form:
Age:0.3
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2010-04-07
Entered:2010-04-07
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: Crying, Diet refusal, Intussusception, X-ray abnormal, Enema administration, Ultrasound scan 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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ultrasound scan, intussusception; X-ray, intussusception
CDC 'Split Type': B0645429A

Write-up: This case was reported by a foreign regulatory authority (AM20090420) and described the occurrence of intussusception of intestine in a 3-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). Medical conditions and concurrent medications were unspecified. The subject weighted 5.8 kg and measured 57 cm. On an unspecified date, the subject received a 1st dose of ROTARIX (batch unknown, oral). Three days after vaccination with ROTARIX, the subject was hospitalized for crying and refusal to eat. Ultrasound scan and X-ray showed intussusception of intestine, reduced by hydrosoluble enema. All the events resolved. According to the foreign method of assessment, the relationship between vaccination with ROTARIX and the reported events was dubious.


Changed on 9/14/2017

VAERS ID: 384490 Before After
VAERS Form:(blank) 1
Age:0.3
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2010-04-07
Entered:2010-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 0 1 - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Crying, Diet refusal, Intussusception, X-ray abnormal, Enema administration, Ultrasound scan 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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ultrasound scan, intussusception; X-ray, intussusception
CDC 'Split Type': B0645429A

Write-up: This case was reported by a foreign regulatory authority (AM20090420) and described the occurrence of intussusception of intestine in a 3-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). Medical conditions and concurrent medications were unspecified. The subject weighted 5.8 kg and measured 57 cm. On an unspecified date, the subject received a 1st dose of ROTARIX (batch unknown, oral). Three days after vaccination with ROTARIX, the subject was hospitalized for crying and refusal to eat. Ultrasound scan and X-ray showed intussusception of intestine, reduced by hydrosoluble enema. All the events resolved. According to the foreign method of assessment, the relationship between vaccination with ROTARIX and the reported events was dubious.


Changed on 2/14/2018

VAERS ID: 384490 Before After
VAERS Form:1
Age:0.3
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2010-04-07
Entered:2010-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Crying, Diet refusal, Intussusception, X-ray abnormal, Enema administration, Ultrasound scan 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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ultrasound scan, intussusception; X-ray, intussusception
CDC 'Split Type': B0645429A

Write-up: This case was reported by a foreign regulatory authority (AM20090420) and described the occurrence of intussusception of intestine in a 3-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). Medical conditions and concurrent medications were unspecified. The subject weighted 5.8 kg and measured 57 cm. On an unspecified date, the subject received a 1st dose of ROTARIX (batch unknown, oral). Three days after vaccination with ROTARIX, the subject was hospitalized for crying and refusal to eat. Ultrasound scan and X-ray showed intussusception of intestine, reduced by hydrosoluble enema. All the events resolved. According to the foreign method of assessment, the relationship between vaccination with ROTARIX and the reported events was dubious.


Changed on 6/14/2018

VAERS ID: 384490 Before After
VAERS Form:1
Age:0.3
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2010-04-07
Entered:2010-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Crying, Diet refusal, Intussusception, X-ray abnormal, Enema administration, Ultrasound scan 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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ultrasound scan, intussusception; X-ray, intussusception
CDC 'Split Type': B0645429A

Write-up: This case was reported by a foreign regulatory authority (AM20090420) and described the occurrence of intussusception of intestine in a 3-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). Medical conditions and concurrent medications were unspecified. The subject weighted 5.8 kg and measured 57 cm. On an unspecified date, the subject received a 1st dose of ROTARIX (batch unknown, oral). Three days after vaccination with ROTARIX, the subject was hospitalized for crying and refusal to eat. Ultrasound scan and X-ray showed intussusception of intestine, reduced by hydrosoluble enema. All the events resolved. According to the foreign method of assessment, the relationship between vaccination with ROTARIX and the reported events was dubious.


Changed on 8/14/2018

VAERS ID: 384490 Before After
VAERS Form:1
Age:0.3
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2010-04-07
Entered:2010-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Crying, Diet refusal, Intussusception, X-ray abnormal, Enema administration, Ultrasound scan 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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ultrasound scan, intussusception; X-ray, intussusception
CDC 'Split Type': B0645429A

Write-up: This case was reported by a foreign regulatory authority (AM20090420) and described the occurrence of intussusception of intestine in a 3-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). Medical conditions and concurrent medications were unspecified. The subject weighted 5.8 kg and measured 57 cm. On an unspecified date, the subject received a 1st dose of ROTARIX (batch unknown, oral). Three days after vaccination with ROTARIX, the subject was hospitalized for crying and refusal to eat. Ultrasound scan and X-ray showed intussusception of intestine, reduced by hydrosoluble enema. All the events resolved. According to the foreign method of assessment, the relationship between vaccination with ROTARIX and the reported events was dubious.


Changed on 9/14/2018

VAERS ID: 384490 Before After
VAERS Form:1
Age:0.3
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2010-04-07
Entered:2010-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Crying, Diet refusal, Intussusception, X-ray abnormal, Enema administration, Ultrasound scan 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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ultrasound scan, intussusception; X-ray, intussusception
CDC 'Split Type': B0645429A

Write-up: This case was reported by a foreign regulatory authority (AM20090420) and described the occurrence of intussusception of intestine in a 3-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). Medical conditions and concurrent medications were unspecified. The subject weighted 5.8 kg and measured 57 cm. On an unspecified date, the subject received a 1st dose of ROTARIX (batch unknown, oral). Three days after vaccination with ROTARIX, the subject was hospitalized for crying and refusal to eat. Ultrasound scan and X-ray showed intussusception of intestine, reduced by hydrosoluble enema. All the events resolved. According to the foreign method of assessment, the relationship between vaccination with ROTARIX and the reported events was dubious.


Changed on 10/14/2018

VAERS ID: 384490 Before After
VAERS Form:1
Age:0.3
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2010-04-07
Entered:2010-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Crying, Diet refusal, Intussusception, X-ray abnormal, Enema administration, Ultrasound scan 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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ultrasound scan, intussusception; X-ray, intussusception
CDC 'Split Type': B0645429A

Write-up: This case was reported by a foreign regulatory authority (AM20090420) and described the occurrence of intussusception of intestine in a 3-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). Medical conditions and concurrent medications were unspecified. The subject weighted 5.8 kg and measured 57 cm. On an unspecified date, the subject received a 1st dose of ROTARIX (batch unknown, oral). Three days after vaccination with ROTARIX, the subject was hospitalized for crying and refusal to eat. Ultrasound scan and X-ray showed intussusception of intestine, reduced by hydrosoluble enema. All the events resolved. According to the foreign method of assessment, the relationship between vaccination with ROTARIX and the reported events was dubious.

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