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This is VAERS ID 266155

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 266155
VAERS Form:
Age:0.2
Gender:Female
Location:North Dakota
Vaccinated:2006-10-13
Onset:2006-10-18
Submitted:2006-11-03
Entered:2006-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS VACCINE, LIVE, ORAL, PENTAVALENT (ROTATEQ) / MERCK & CO. INC. 0695F / 0 UN / -

Administered by: Other      Purchased by: Unknown
Symptoms: Agitation, Crying, Intussusception, Muscle spasms, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ultrasound 10/18/2006 intussusception.
CDC 'Split Type':

Write-up: Information has been received from a physician concerning a 11 week old female who on 10/13/06 was vaccinated with the first 2.0ml dose of Rotavirus G1 G2 G3 G4 P1 reassortant vaccine live (human Bovine) (lot 654504/0695F). The physician reported that on"10/18/06, the pt developed severe vomiting. The pt was vomiting so much that she was hospitalized where an ultra sound was performed and a diagnosis of intussusception was made. On the evening of 10/18/06, the intussusception was reduced by Barium enema.


Changed on 12/8/2009

VAERS ID: 266155 Before After
VAERS Form:
Age:0.2
Gender:Female
Location:North Dakota
Vaccinated:2006-10-13
Onset:2006-10-18
Submitted:2006-11-03
Entered:2006-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS VACCINE, LIVE, ORAL, PENTAVALENT (ROTATEQ) ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0695F / 0 UN / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Agitation, Crying, Intussusception, Muscle spasms, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ultrasound 10/18/2006 intussusception.
CDC 'Split Type': (blank) WAES0610USA13121

Write-up: Information has been received from a physician concerning a 11 week old female who on 10/13/06 was vaccinated with the first 2.0ml dose of Rotavirus G1 G2 G3 G4 P1 reassortant vaccine live (human Bovine) (lot 654504/0695F). The physician reported that on"10/18/06, on 10/18/06, the pt developed severe vomiting. The pt was vomiting so much that she was hospitalized where an ultra sound was performed and a diagnosis of intussusception was made. On the evening of 10/18/06, the intussusception was reduced by Barium enema. It was noted that the pt experienced cramping, crying and whining until midnight. On 10/19/2006, the pt was discharged from the hospital as her intussusception was considered to be resolved. The physician also considered the intussusception to be life threatening. Additional information has been requested.


Changed on 5/13/2013

VAERS ID: 266155 Before After
VAERS Form:
Age:0.2
Gender:Female
Location:North Dakota
Vaccinated:2006-10-13
Onset:2006-10-18
Submitted:2006-11-03
Entered:2006-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0695F / 0 UN / -
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0695F / 0 UN / -

Administered by: Other      Purchased by: Other
Symptoms: Agitation, Crying, Intussusception, Muscle spasms, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ultrasound 10/18/2006 intussusception.
CDC 'Split Type': WAES0610USA13121

Write-up: Information has been received from a physician concerning a 11 week old female who on 10/13/06 was vaccinated with the first 2.0ml dose of Rotavirus G1 G2 G3 G4 P1 reassortant vaccine live (human Bovine) (lot 654504/0695F). The physician reported that on 10/18/06, the pt developed severe vomiting. The pt was vomiting so much that she was hospitalized where an ultra sound was performed and a diagnosis of intussusception was made. On the evening of 10/18/06, the intussusception was reduced by Barium enema. It was noted that the pt experienced cramping, crying and whining until midnight. On 10/19/2006, the pt was discharged from the hospital as her intussusception was considered to be resolved. The physician also considered the intussusception to be life threatening. Additional information has been requested.


Changed on 9/14/2017

VAERS ID: 266155 Before After
VAERS Form:(blank) 1
Age:0.2
Gender:Female
Location:North Dakota
Vaccinated:2006-10-13
Onset:2006-10-18
Submitted:2006-11-03
Entered:2006-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0695F / 0 1 UN / -

Administered by: Other      Purchased by: Other
Symptoms: Agitation, Crying, Intussusception, Muscle spasms, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ultrasound 10/18/2006 intussusception.
CDC 'Split Type': WAES0610USA13121

Write-up: Information has been received from a physician concerning a 11 week old female who on 10/13/06 was vaccinated with the first 2.0ml dose of Rotavirus G1 G2 G3 G4 P1 reassortant vaccine live (human Bovine) (lot 654504/0695F). The physician reported that on 10/18/06, the pt developed severe vomiting. The pt was vomiting so much that she was hospitalized where an ultra sound was performed and a diagnosis of intussusception was made. On the evening of 10/18/06, the intussusception was reduced by Barium enema. It was noted that the pt experienced cramping, crying and whining until midnight. On 10/19/2006, the pt was discharged from the hospital as her intussusception was considered to be resolved. The physician also considered the intussusception to be life threatening. Additional information has been requested.


Changed on 2/14/2018

VAERS ID: 266155 Before After
VAERS Form:1
Age:0.2
Gender:Female
Location:North Dakota
Vaccinated:2006-10-13
Onset:2006-10-18
Submitted:2006-11-03
Entered:2006-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0695F / 1 UN / -

Administered by: Other      Purchased by: Other
Symptoms: Agitation, Crying, Intussusception, Muscle spasms, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ultrasound 10/18/2006 intussusception.
CDC 'Split Type': WAES0610USA13121

Write-up: Information has been received from a physician concerning a 11 week old female who on 10/13/06 was vaccinated with the first 2.0ml dose of Rotavirus G1 G2 G3 G4 P1 reassortant vaccine live (human Bovine) (lot 654504/0695F). The physician reported that on 10/18/06, the pt developed severe vomiting. The pt was vomiting so much that she was hospitalized where an ultra sound was performed and a diagnosis of intussusception was made. On the evening of 10/18/06, the intussusception was reduced by Barium enema. It was noted that the pt experienced cramping, crying and whining until midnight. On 10/19/2006, the pt was discharged from the hospital as her intussusception was considered to be resolved. The physician also considered the intussusception to be life threatening. Additional information has been requested.


Changed on 6/14/2018

VAERS ID: 266155 Before After
VAERS Form:1
Age:0.2
Gender:Female
Location:North Dakota
Vaccinated:2006-10-13
Onset:2006-10-18
Submitted:2006-11-03
Entered:2006-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0695F / 1 UN / -

Administered by: Other      Purchased by: Other
Symptoms: Agitation, Crying, Intussusception, Muscle spasms, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ultrasound 10/18/2006 intussusception.
CDC 'Split Type': WAES0610USA13121

Write-up: Information has been received from a physician concerning a 11 week old female who on 10/13/06 was vaccinated with the first 2.0ml dose of Rotavirus G1 G2 G3 G4 P1 reassortant vaccine live (human Bovine) (lot 654504/0695F). The physician reported that on 10/18/06, the pt developed severe vomiting. The pt was vomiting so much that she was hospitalized where an ultra sound was performed and a diagnosis of intussusception was made. On the evening of 10/18/06, the intussusception was reduced by Barium enema. It was noted that the pt experienced cramping, crying and whining until midnight. On 10/19/2006, the pt was discharged from the hospital as her intussusception was considered to be resolved. The physician also considered the intussusception to be life threatening. Additional information has been requested.

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