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This is VAERS ID 389388

History of Changes from the VAERS Wayback Machine

First Appeared on 6/2/2010

VAERS ID: 389388
VAERS Form:
Age:0.2
Sex:Female
Location:Foreign
Vaccinated:2009-08-20
Onset:2010-05-12
Submitted:2010-05-26
Entered:2010-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
6VAX-F: DTAP+IPV+HEPB+HIB (UNKNOWN) / GLAXOSMITHKLINE BIOLOGICALS (UNKNOWN) A21CA539B / - UN / UN
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC - / - UN / UN
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CA761A / - - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Barium enema, Gastroenteritis, Intensive care, Intussusception, Small intestinal resection, Vomiting, Colectomy

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: UNK
CDC 'Split Type': B0656738A

Write-up: This case was reported by a nurse and described the occurrence of intussusception in a 10-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline), INFANRIX HEXA and PREVENAR (non-gsk). On 20 August 2009, the subject received an unspecified dose of ROTARIX (oral), an unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 21 September 2009, the subject received an unspecified dose of ROTARIX (oral). An unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 22 October 2009, the subject received an unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 12 May 2010, 7 months after vaccination with INFANRIX HEXA and PREVENAR, 8 months after vaccination with INFANRIX HEXA, PREVENAR and ROTARIX, 9 months after vaccination with INFANRIX HEXA, PREVENAR and ROTARIX, the subject experienced vomiting with severe abdominal pain. He was admitted for gastroenteritis. On 13 May 2010, intussusception was diagnosed with barium enema right hemicolectomy and a small bowel resection was done the same day. The subject was hospitalised 2 days in ICU and then ward. At the time of reporting, the outcome of the events was unspecified. Further information has been expected.


Changed on 8/31/2010

VAERS ID: 389388 Before After
VAERS Form:
Age:0.2
Sex:Female
Location:Foreign
Vaccinated:2009-08-20
Onset:2010-05-12
Submitted:2010-05-26
Entered:2010-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
6VAX-F: DTAP+IPV+HEPB+HIB (UNKNOWN) DTAP+IPV+HEPB+HIB (NO BRAND NAME) / GLAXOSMITHKLINE BIOLOGICALS (UNKNOWN) A21CA539B / - UN / UN
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH - / - UN / UN
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CA761A / - - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Barium enema, Gastroenteritis, Intensive care, Intussusception, Small intestinal resection, Vomiting, Colectomy

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: UNK
CDC 'Split Type': B0656738A

Write-up: This case was reported by a nurse and described the occurrence of intussusception in a 10-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline), INFANRIX HEXA and PREVENAR (non-gsk). On 20 August 2009, the subject received an unspecified dose of ROTARIX (oral), an unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 21 September 2009, the subject received an unspecified dose of ROTARIX (oral). An unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 22 October 2009, the subject received an unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 12 May 2010, 7 months after vaccination with INFANRIX HEXA and PREVENAR, 8 months after vaccination with INFANRIX HEXA, PREVENAR and ROTARIX, 9 months after vaccination with INFANRIX HEXA, PREVENAR and ROTARIX, the subject experienced vomiting with severe abdominal pain. He was admitted for gastroenteritis. On 13 May 2010, intussusception was diagnosed with barium enema right hemicolectomy and a small bowel resection was done the same day. The subject was hospitalised 2 days in ICU and then ward. At the time of reporting, the outcome of the events was unspecified. Further information has been expected.


Changed on 11/3/2010

VAERS ID: 389388 Before After
VAERS Form:
Age:0.2
Sex:Female
Location:Foreign
Vaccinated:2009-08-20
Onset:2010-05-12
Submitted:2010-05-26
Entered:2010-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
6VAX-F: DTAP+IPV+HEPB+HIB (NO BRAND NAME) DTAP+IPV+HEPB+HIB (FOREIGN) / GLAXOSMITHKLINE BIOLOGICALS (UNKNOWN) A21CA539B / - UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / - UN / UN
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CA761A / - - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Barium enema, Gastroenteritis, Intensive care, Intussusception, Small intestinal resection, Vomiting, Colectomy

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: UNK
CDC 'Split Type': B0656738A

Write-up: This case was reported by a nurse and described the occurrence of intussusception in a 10-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline), INFANRIX HEXA and PREVENAR (non-gsk). On 20 August 2009, the subject received an unspecified dose of ROTARIX (oral), an unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 21 September 2009, the subject received an unspecified dose of ROTARIX (oral). An unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 22 October 2009, the subject received an unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 12 May 2010, 7 months after vaccination with INFANRIX HEXA and PREVENAR, 8 months after vaccination with INFANRIX HEXA, PREVENAR and ROTARIX, 9 months after vaccination with INFANRIX HEXA, PREVENAR and ROTARIX, the subject experienced vomiting with severe abdominal pain. He was admitted for gastroenteritis. On 13 May 2010, intussusception was diagnosed with barium enema right hemicolectomy and a small bowel resection was done the same day. The subject was hospitalised 2 days in ICU and then ward. At the time of reporting, the outcome of the events was unspecified. Further information has been expected.


Changed on 1/4/2011

VAERS ID: 389388 Before After
VAERS Form:
Age:0.2
Sex:Female
Location:Foreign
Vaccinated:2009-08-20
Onset:2010-05-12
Submitted:2010-05-26
Entered:2010-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
6VAX-F: DTAP+IPV+HEPB+HIB (FOREIGN) / GLAXOSMITHKLINE BIOLOGICALS (UNKNOWN) GLAXOSMITHKLINE BIOLOGICALS A21CA539B / - UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / - UN / UN
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CA761A / - - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Barium enema, Gastroenteritis, Intensive care, Intussusception, Small intestinal resection, Vomiting, Colectomy

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: UNK
CDC 'Split Type': B0656738A

Write-up: This case was reported by a nurse and described the occurrence of intussusception in a 10-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline), INFANRIX HEXA and PREVENAR (non-gsk). On 20 August 2009, the subject received an unspecified dose of ROTARIX (oral), an unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 21 September 2009, the subject received an unspecified dose of ROTARIX (oral). An unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 22 October 2009, the subject received an unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 12 May 2010, 7 months after vaccination with INFANRIX HEXA and PREVENAR, 8 months after vaccination with INFANRIX HEXA, PREVENAR and ROTARIX, 9 months after vaccination with INFANRIX HEXA, PREVENAR and ROTARIX, the subject experienced vomiting with severe abdominal pain. He was admitted for gastroenteritis. On 13 May 2010, intussusception was diagnosed with barium enema right hemicolectomy and a small bowel resection was done the same day. The subject was hospitalised 2 days in ICU and then ward. At the time of reporting, the outcome of the events was unspecified. Further information has been expected.


Changed on 5/13/2013

VAERS ID: 389388 Before After
VAERS Form:
Age:0.2
Sex:Female
Location:Foreign
Vaccinated:2009-08-20
Onset:2010-05-12
Submitted:2010-05-26
Entered:2010-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
6VAX-F: DTAP+IPV+HEPB+HIB (FOREIGN) / GLAXOSMITHKLINE BIOLOGICALS A21CA539B / - UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / - UN / UN
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CA761A / - - / PO
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CA761A / - - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Barium enema, Gastroenteritis, Intensive care, Intussusception, Small intestinal resection, Vomiting, Colectomy

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: UNK
CDC 'Split Type': B0656738A

Write-up: This case was reported by a nurse and described the occurrence of intussusception in a 10-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline), INFANRIX HEXA and PREVENAR (non-gsk). On 20 August 2009, the subject received an unspecified dose of ROTARIX (oral), an unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 21 September 2009, the subject received an unspecified dose of ROTARIX (oral). An unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 22 October 2009, the subject received an unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 12 May 2010, 7 months after vaccination with INFANRIX HEXA and PREVENAR, 8 months after vaccination with INFANRIX HEXA, PREVENAR and ROTARIX, 9 months after vaccination with INFANRIX HEXA, PREVENAR and ROTARIX, the subject experienced vomiting with severe abdominal pain. He was admitted for gastroenteritis. On 13 May 2010, intussusception was diagnosed with barium enema right hemicolectomy and a small bowel resection was done the same day. The subject was hospitalised 2 days in ICU and then ward. At the time of reporting, the outcome of the events was unspecified. Further information has been expected.


Changed on 2/14/2017

VAERS ID: 389388 Before After
VAERS Form:
Age:0.2 0.16
Sex:Female
Location:Foreign
Vaccinated:2009-08-20
Onset:2010-05-12
Submitted:2010-05-26
Entered:2010-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
6VAX-F: DTAP+IPV+HEPB+HIB (FOREIGN) / GLAXOSMITHKLINE BIOLOGICALS A21CA539B / - UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / - UN / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CA761A / - - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Barium enema, Gastroenteritis, Intensive care, Intussusception, Small intestinal resection, Vomiting, Colectomy

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: UNK
CDC 'Split Type': B0656738A

Write-up: This case was reported by a nurse and described the occurrence of intussusception in a 10-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline), INFANRIX HEXA and PREVENAR (non-gsk). On 20 August 2009, the subject received an unspecified dose of ROTARIX (oral), an unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 21 September 2009, the subject received an unspecified dose of ROTARIX (oral). An unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 22 October 2009, the subject received an unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 12 May 2010, 7 months after vaccination with INFANRIX HEXA and PREVENAR, 8 months after vaccination with INFANRIX HEXA, PREVENAR and ROTARIX, 9 months after vaccination with INFANRIX HEXA, PREVENAR and ROTARIX, the subject experienced vomiting with severe abdominal pain. He was admitted for gastroenteritis. On 13 May 2010, intussusception was diagnosed with barium enema right hemicolectomy and a small bowel resection was done the same day. The subject was hospitalised 2 days in ICU and then ward. At the time of reporting, the outcome of the events was unspecified. Further information has been expected.


Changed on 5/14/2017

VAERS ID: 389388 Before After
VAERS Form:
Age:0.16
Sex:Female
Location:Foreign
Vaccinated:2009-08-20
Onset:2010-05-12
Submitted:2010-05-26
Entered:2010-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
6VAX-F: DTAP+IPV+HEPB+HIB (FOREIGN) DTAP+IPV+HEPB+HIB (INFANRIX HEXA) / GLAXOSMITHKLINE BIOLOGICALS A21CA539B / - UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / - UN / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CA761A / - - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Barium enema, Gastroenteritis, Intensive care, Intussusception, Small intestinal resection, Vomiting, Colectomy

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: UNK
CDC 'Split Type': B0656738A

Write-up: This case was reported by a nurse and described the occurrence of intussusception in a 10-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline), INFANRIX HEXA and PREVENAR (non-gsk). On 20 August 2009, the subject received an unspecified dose of ROTARIX (oral), an unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 21 September 2009, the subject received an unspecified dose of ROTARIX (oral). An unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 22 October 2009, the subject received an unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 12 May 2010, 7 months after vaccination with INFANRIX HEXA and PREVENAR, 8 months after vaccination with INFANRIX HEXA, PREVENAR and ROTARIX, 9 months after vaccination with INFANRIX HEXA, PREVENAR and ROTARIX, the subject experienced vomiting with severe abdominal pain. He was admitted for gastroenteritis. On 13 May 2010, intussusception was diagnosed with barium enema right hemicolectomy and a small bowel resection was done the same day. The subject was hospitalised 2 days in ICU and then ward. At the time of reporting, the outcome of the events was unspecified. Further information has been expected.


Changed on 9/14/2017

VAERS ID: 389388 Before After
VAERS Form:(blank) 1
Age:0.16
Sex:Female
Location:Foreign
Vaccinated:2009-08-20
Onset:2010-05-12
Submitted:2010-05-26
Entered:2010-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
6VAX-F: DTAP+IPV+HEPB+HIB (INFANRIX HEXA) / GLAXOSMITHKLINE BIOLOGICALS A21CA539B / - UNK UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / - UNK UN / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CA761A / - UNK - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Barium enema, Gastroenteritis, Intensive care, Intussusception, Small intestinal resection, Vomiting, Colectomy

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: UNK
CDC 'Split Type': B0656738A

Write-up: This case was reported by a nurse and described the occurrence of intussusception in a 10-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline), INFANRIX HEXA and PREVENAR (non-gsk). On 20 August 2009, the subject received an unspecified dose of ROTARIX (oral), an unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 21 September 2009, the subject received an unspecified dose of ROTARIX (oral). An unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 22 October 2009, the subject received an unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 12 May 2010, 7 months after vaccination with INFANRIX HEXA and PREVENAR, 8 months after vaccination with INFANRIX HEXA, PREVENAR and ROTARIX, 9 months after vaccination with INFANRIX HEXA, PREVENAR and ROTARIX, the subject experienced vomiting with severe abdominal pain. He was admitted for gastroenteritis. On 13 May 2010, intussusception was diagnosed with barium enema right hemicolectomy and a small bowel resection was done the same day. The subject was hospitalised 2 days in ICU and then ward. At the time of reporting, the outcome of the events was unspecified. Further information has been expected.


Changed on 2/14/2018

VAERS ID: 389388 Before After
VAERS Form:1
Age:0.16
Sex:Female
Location:Foreign
Vaccinated:2009-08-20
Onset:2010-05-12
Submitted:2010-05-26
Entered:2010-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
6VAX-F: DTAP+IPV+HEPB+HIB (INFANRIX HEXA) / GLAXOSMITHKLINE BIOLOGICALS A21CA539B / UNK UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / UNK UN / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CA761A / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Barium enema, Gastroenteritis, Intensive care, Intussusception, Small intestinal resection, Vomiting, Colectomy

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: UNK
CDC 'Split Type': B0656738A

Write-up: This case was reported by a nurse and described the occurrence of intussusception in a 10-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline), INFANRIX HEXA and PREVENAR (non-gsk). On 20 August 2009, the subject received an unspecified dose of ROTARIX (oral), an unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 21 September 2009, the subject received an unspecified dose of ROTARIX (oral). An unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 22 October 2009, the subject received an unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 12 May 2010, 7 months after vaccination with INFANRIX HEXA and PREVENAR, 8 months after vaccination with INFANRIX HEXA, PREVENAR and ROTARIX, 9 months after vaccination with INFANRIX HEXA, PREVENAR and ROTARIX, the subject experienced vomiting with severe abdominal pain. He was admitted for gastroenteritis. On 13 May 2010, intussusception was diagnosed with barium enema right hemicolectomy and a small bowel resection was done the same day. The subject was hospitalised 2 days in ICU and then ward. At the time of reporting, the outcome of the events was unspecified. Further information has been expected.


Changed on 6/14/2018

VAERS ID: 389388 Before After
VAERS Form:1
Age:0.16
Sex:Female
Location:Foreign
Vaccinated:2009-08-20
Onset:2010-05-12
Submitted:2010-05-26
Entered:2010-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
6VAX-F: DTAP+IPV+HEPB+HIB (INFANRIX HEXA) / GLAXOSMITHKLINE BIOLOGICALS A21CA539B / UNK UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / UNK UN / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CA761A / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Barium enema, Gastroenteritis, Intensive care, Intussusception, Small intestinal resection, Vomiting, Colectomy

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: UNK
CDC 'Split Type': B0656738A

Write-up: This case was reported by a nurse and described the occurrence of intussusception in a 10-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline), INFANRIX HEXA and PREVENAR (non-gsk). On 20 August 2009, the subject received an unspecified dose of ROTARIX (oral), an unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 21 September 2009, the subject received an unspecified dose of ROTARIX (oral). An unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 22 October 2009, the subject received an unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 12 May 2010, 7 months after vaccination with INFANRIX HEXA and PREVENAR, 8 months after vaccination with INFANRIX HEXA, PREVENAR and ROTARIX, 9 months after vaccination with INFANRIX HEXA, PREVENAR and ROTARIX, the subject experienced vomiting with severe abdominal pain. He was admitted for gastroenteritis. On 13 May 2010, intussusception was diagnosed with barium enema right hemicolectomy and a small bowel resection was done the same day. The subject was hospitalised 2 days in ICU and then ward. At the time of reporting, the outcome of the events was unspecified. Further information has been expected.


Changed on 8/14/2018

VAERS ID: 389388 Before After
VAERS Form:1
Age:0.16
Sex:Female
Location:Foreign
Vaccinated:2009-08-20
Onset:2010-05-12
Submitted:2010-05-26
Entered:2010-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
6VAX-F: DTAP+IPV+HEPB+HIB (INFANRIX HEXA) / GLAXOSMITHKLINE BIOLOGICALS A21CA539B / UNK UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / UNK UN / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CA761A / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Barium enema, Gastroenteritis, Intensive care, Intussusception, Small intestinal resection, Vomiting, Colectomy

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: UNK
CDC 'Split Type': B0656738A

Write-up: This case was reported by a nurse and described the occurrence of intussusception in a 10-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline), INFANRIX HEXA and PREVENAR (non-gsk). On 20 August 2009, the subject received an unspecified dose of ROTARIX (oral), an unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 21 September 2009, the subject received an unspecified dose of ROTARIX (oral). An unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 22 October 2009, the subject received an unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 12 May 2010, 7 months after vaccination with INFANRIX HEXA and PREVENAR, 8 months after vaccination with INFANRIX HEXA, PREVENAR and ROTARIX, 9 months after vaccination with INFANRIX HEXA, PREVENAR and ROTARIX, the subject experienced vomiting with severe abdominal pain. He was admitted for gastroenteritis. On 13 May 2010, intussusception was diagnosed with barium enema right hemicolectomy and a small bowel resection was done the same day. The subject was hospitalised 2 days in ICU and then ward. At the time of reporting, the outcome of the events was unspecified. Further information has been expected.


Changed on 9/14/2018

VAERS ID: 389388 Before After
VAERS Form:1
Age:0.16
Sex:Female
Location:Foreign
Vaccinated:2009-08-20
Onset:2010-05-12
Submitted:2010-05-26
Entered:2010-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
6VAX-F: DTAP+IPV+HEPB+HIB (INFANRIX HEXA) / GLAXOSMITHKLINE BIOLOGICALS A21CA539B / UNK UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / UNK UN / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CA761A / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Barium enema, Gastroenteritis, Intensive care, Intussusception, Small intestinal resection, Vomiting, Colectomy

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: UNK
CDC 'Split Type': B0656738A

Write-up: This case was reported by a nurse and described the occurrence of intussusception in a 10-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline), INFANRIX HEXA and PREVENAR (non-gsk). On 20 August 2009, the subject received an unspecified dose of ROTARIX (oral), an unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 21 September 2009, the subject received an unspecified dose of ROTARIX (oral). An unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 22 October 2009, the subject received an unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 12 May 2010, 7 months after vaccination with INFANRIX HEXA and PREVENAR, 8 months after vaccination with INFANRIX HEXA, PREVENAR and ROTARIX, 9 months after vaccination with INFANRIX HEXA, PREVENAR and ROTARIX, the subject experienced vomiting with severe abdominal pain. He was admitted for gastroenteritis. On 13 May 2010, intussusception was diagnosed with barium enema right hemicolectomy and a small bowel resection was done the same day. The subject was hospitalised 2 days in ICU and then ward. At the time of reporting, the outcome of the events was unspecified. Further information has been expected.


Changed on 10/14/2018

VAERS ID: 389388 Before After
VAERS Form:1
Age:0.16
Sex:Female
Location:Foreign
Vaccinated:2009-08-20
Onset:2010-05-12
Submitted:2010-05-26
Entered:2010-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
6VAX-F: DTAP+IPV+HEPB+HIB (INFANRIX HEXA) / GLAXOSMITHKLINE BIOLOGICALS A21CA539B / UNK UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / UNK UN / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CA761A / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Barium enema, Gastroenteritis, Intensive care, Intussusception, Small intestinal resection, Vomiting, Colectomy

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: UNK
CDC 'Split Type': B0656738A

Write-up: This case was reported by a nurse and described the occurrence of intussusception in a 10-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline), INFANRIX HEXA and PREVENAR (non-gsk). On 20 August 2009, the subject received an unspecified dose of ROTARIX (oral), an unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 21 September 2009, the subject received an unspecified dose of ROTARIX (oral). An unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 22 October 2009, the subject received an unspecified dose of INFANRIX HEXA (administration site and route unknown) and an unspecified dose of PREVENAR. On 12 May 2010, 7 months after vaccination with INFANRIX HEXA and PREVENAR, 8 months after vaccination with INFANRIX HEXA, PREVENAR and ROTARIX, 9 months after vaccination with INFANRIX HEXA, PREVENAR and ROTARIX, the subject experienced vomiting with severe abdominal pain. He was admitted for gastroenteritis. On 13 May 2010, intussusception was diagnosed with barium enema right hemicolectomy and a small bowel resection was done the same day. The subject was hospitalised 2 days in ICU and then ward. At the time of reporting, the outcome of the events was unspecified. Further information has been expected.

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