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This is VAERS ID 268405

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 268405
VAERS Form:
Age:0.4
Gender:Female
Location:South Carolina
Vaccinated:2006-11-27
Onset:2006-11-29
Submitted:2006-12-04
Entered:2006-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (UNKNOWN MFR) / UNKNOWN MANUFACTURER - / - UN / -
HIBV: HIB (UNKNOWN MFR) / UNKNOWN MANUFACTURER - / - UN / -
IPV: POLIO VIRUS, INACT. (IPOL) / AVENTIS PASTEUR, INC. - / - UN / -
PNC: PNEUMO, 7-VALENT (PREVNAR) / LEDERLE LABORATORIES - / - UN / -
ROTHB5: ROTAVIRUS VACCINE, LIVE, ORAL, PENTAVALENT (ROTATEQ) / MERCK & CO. INC. 1034F / - - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intestinal gangrene, Intestinal obstruction, Intussusception, Vomiting

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 2 days after Rotateq, patient began vomiting 11/29/06 ultrasound on 12/1/06 showed signs of obstruction and . Abdomen-surgery on 12/1/06 revealed intussusception with gangrenous ascending and transverse colon-after, colectomy of involved segment Andre-an"astomosis. Patient is doing well.


Changed on 12/8/2009

VAERS ID: 268405 Before After
VAERS Form:
Age:0.4
Gender:Female
Location:South Carolina
Vaccinated:2006-11-27
Onset:2006-11-29
Submitted:2006-12-04
Entered:2006-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (UNKNOWN MFR) DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / -
HIBV: HIB (UNKNOWN MFR) HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / -
IPV: POLIO VIRUS, INACT. (IPOL) / AVENTIS PASTEUR, INC. SANOFI PASTEUR - / - UN / -
PNC: PNEUMO, 7-VALENT (PREVNAR) PNEUMO (PREVNAR) / LEDERLE LABORATORIES WYETH PHARMACEUTICALS, INC - / - UN / -
ROTHB5: ROTAVIRUS VACCINE, LIVE, ORAL, PENTAVALENT (ROTATEQ) ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1034F / - - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intestinal gangrene, Intestinal obstruction, Intussusception, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No 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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 2 days after Rotateq, patient began vomiting 11/29/06 ultrasound on 12/1/06 showed signs of obstruction and . Abdomen-surgery on 12/1/06 revealed intussusception with gangrenous ascending and transverse colon-after, colectomy of involved segment Andre-an"astomosis. Andre-anastomosis. Patient is doing well.


Changed on 3/2/2010

VAERS ID: 268405 Before After
VAERS Form:
Age:0.4
Gender:Female
Location:South Carolina
Vaccinated:2006-11-27
Onset:2006-11-29
Submitted:2006-12-04
Entered:2006-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / -
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / -
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / - UN / -
PNC: PNEUMO (PREVNAR) PNEUMO (PREVNAR7) / WYETH PHARMACEUTICALS, INC - / - UN / -
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1034F / - - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intestinal gangrene, Intestinal obstruction, Intussusception, Vomiting

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 2 days after Rotateq, patient began vomiting 11/29/06 ultrasound on 12/1/06 showed signs of obstruction and . Abdomen-surgery on 12/1/06 revealed intussusception with gangrenous ascending and transverse colon-after, colectomy of involved segment Andre-anastomosis. Patient is doing well.


Changed on 4/7/2010

VAERS ID: 268405 Before After
VAERS Form:
Age:0.4
Gender:Female
Location:South Carolina
Vaccinated:2006-11-27
Onset:2006-11-29
Submitted:2006-12-04
Entered:2006-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / -
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / -
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / - UN / -
PNC: PNEUMO (PREVNAR7) PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC - / - UN / -
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1034F / - - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intestinal gangrene, Intestinal obstruction, Intussusception, Vomiting

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 2 days after Rotateq, patient began vomiting 11/29/06 ultrasound on 12/1/06 showed signs of obstruction and . Abdomen-surgery on 12/1/06 revealed intussusception with gangrenous ascending and transverse colon-after, colectomy of involved segment Andre-anastomosis. Patient is doing well.


Changed on 8/31/2010

VAERS ID: 268405 Before After
VAERS Form:
Age:0.4
Gender:Female
Location:South Carolina
Vaccinated:2006-11-27
Onset:2006-11-29
Submitted:2006-12-04
Entered:2006-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / -
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / -
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / - UN / -
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH - / - UN / -
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1034F / - - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intestinal gangrene, Intestinal obstruction, Intussusception, Vomiting

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 2 days after Rotateq, patient began vomiting 11/29/06 ultrasound on 12/1/06 showed signs of obstruction and . Abdomen-surgery on 12/1/06 revealed intussusception with gangrenous ascending and transverse colon-after, colectomy of involved segment Andre-anastomosis. Patient is doing well.


Changed on 5/13/2013

VAERS ID: 268405 Before After
VAERS Form:
Age:0.4
Gender:Female
Location:South Carolina
Vaccinated:2006-11-27
Onset:2006-11-29
Submitted:2006-12-04
Entered:2006-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / -
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / -
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / - UN / -
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / - UN / -
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1034F / - - / PO
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1034F / - - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intestinal gangrene, Intestinal obstruction, Intussusception, Vomiting

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 2 days after Rotateq, patient began vomiting 11/29/06 ultrasound on 12/1/06 showed signs of obstruction and . Abdomen-surgery on 12/1/06 revealed intussusception with gangrenous ascending and transverse colon-after, colectomy of involved segment Andre-anastomosis. Patient is doing well.


Changed on 2/14/2017

VAERS ID: 268405 Before After
VAERS Form:
Age:0.4 0.42
Gender:Female
Location:South Carolina
Vaccinated:2006-11-27
Onset:2006-11-29
Submitted:2006-12-04
Entered:2006-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / -
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / -
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / - UN / -
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / - UN / -
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1034F / - - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intestinal gangrene, Intestinal obstruction, Intussusception, Vomiting

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 2 days after Rotateq, patient began vomiting 11/29/06 ultrasound on 12/1/06 showed signs of obstruction and . Abdomen-surgery on 12/1/06 revealed intussusception with gangrenous ascending and transverse colon-after, colectomy of involved segment Andre-anastomosis. Patient is doing well.


Changed on 9/14/2017

VAERS ID: 268405 Before After
VAERS Form:(blank) 1
Age:0.42
Gender:Female
Location:South Carolina
Vaccinated:2006-11-27
Onset:2006-11-29
Submitted:2006-12-04
Entered:2006-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK UN / -
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK UN / -
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / - UNK UN / -
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / - UNK UN / -
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1034F / - UNK - MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intestinal gangrene, Intestinal obstruction, Intussusception, Vomiting

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 2 days after Rotateq, patient began vomiting 11/29/06 ultrasound on 12/1/06 showed signs of obstruction and . Abdomen-surgery on 12/1/06 revealed intussusception with gangrenous ascending and transverse colon-after, colectomy of involved segment Andre-anastomosis. Patient is doing well.


Changed on 2/14/2018

VAERS ID: 268405 Before After
VAERS Form:1
Age:0.42
Gender:Female
Location:South Carolina
Vaccinated:2006-11-27
Onset:2006-11-29
Submitted:2006-12-04
Entered:2006-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / -
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / -
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / UNK UN / -
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / UNK UN / -
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1034F / UNK MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intestinal gangrene, Intestinal obstruction, Intussusception, Vomiting

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 2 days after Rotateq, patient began vomiting 11/29/06 ultrasound on 12/1/06 showed signs of obstruction and . Abdomen-surgery on 12/1/06 revealed intussusception with gangrenous ascending and transverse colon-after, colectomy of involved segment Andre-anastomosis. Patient is doing well.


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