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History of Changes from the VAERS Wayback Machine |
First Appeared on 12/31/2007 |
VAERS ID: | 271803 |
VAERS Form: | |
Age: | 0.6 |
Gender: | Female |
Location: | Connecticut |
Vaccinated: | 2006-12-08 |
Onset: | 2007-01-26 |
Submitted: | 2007-01-31 |
Entered: | 2007-02-06 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHE: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B059AA / 2 | LL / IM |
PNC: PNEUMO (PREVNAR) / LEDERLE LABORATORIES | B08658H / 2 | LL / IM |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0411F / 2 | - / PO |
Administered by: Public Purchased by: Unknown
Symptoms: Abdominal mass, Abdominal tenderness, Anorexia, Body temperature, Abdominal X-ray
Life Threatening? Yes
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: 2
Write-up: Intussusception (6 weeks after 3rd dose of Rotavirus vaccine) requiring surgery. 02/16/07-Records reviewed for DOS 01/26-01/28/07- DC DX:Intussusception Surgical procedure:Laparotomy for manual reduction of intussusception. Unreducible intussusception sta"tus post attempted radiographic reduction. Presented with history of vomiting hematechesia loss of appetite fever 100.4 plus. Reports currant jelly or blood stools present. Temp in ER 100.4 PE:WNL except for abdomen soft tenderness in periumbilical mild
Vaccinated: | 2006-12-08 |
Onset: | 2007-01-26 |
Submitted: | 2007-01-31 |
Entered: | 2007-02-06 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHE: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B059AA / 2 | LL / IM |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B059AA / 2 | LL / IM |
PNC: PNEUMO (PREVNAR) / LEDERLE LABORATORIES | B08658H / 2 | LL / IM |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0411F / 2 | - / PO |
Administered by: Public Purchased by: Unknown Public
Symptoms: Abdominal mass, Abdominal tenderness, Anorexia, Body temperature, Bowel sounds abnormal, Haematochezia, Intussusception, Laparotomy, Large intestinal obstruction reduction, Surgery, Vomiting, Abdominal X-ray
Life Threatening? Yes
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: 2
Write-up: Intussusception (6 weeks after 3rd dose of Rotavirus vaccine) requiring surgery. 02/16/07-Records reviewed for DOS 01/26-01/28/07- DC DX:Intussusception Surgical procedure:Laparotomy for manual reduction of intussusception. Unreducible intussusception sta"tus status post attempted radiographic reduction. Presented with history of vomiting hematechesia loss of appetite fever 100.4 plus. Reports currant jelly or blood stools present. Temp in ER 100.4 PE:WNL except for abdomen soft tenderness in periumbilical mild in intensity. Mass soft mobile mass approximately 5cm in diameter to right below of umbilicus, hypoactive bowel sounds. Rectal exam shows empty vault.
Vaccinated: | 2006-12-08 |
Onset: | 2007-01-26 |
Submitted: | 2007-01-31 |
Entered: | 2007-02-06 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B059AA / 2 | LL / IM |
PNC: PNEUMO (PREVNAR) PNEUMO (PREVNAR7) / LEDERLE LABORATORIES | B08658H / 2 | LL / IM |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0411F / 2 | - / PO |
Administered by: Public Purchased by: Public
Symptoms: Abdominal mass, Abdominal tenderness, Anorexia, Body temperature, Bowel sounds abnormal, Haematochezia, Intussusception, Laparotomy, Large intestinal obstruction reduction, Surgery, Vomiting, Abdominal X-ray
Life Threatening? Yes
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: 2
Write-up: Intussusception (6 weeks after 3rd dose of Rotavirus vaccine) requiring surgery. 02/16/07-Records reviewed for DOS 01/26-01/28/07- DC DX:Intussusception Surgical procedure:Laparotomy for manual reduction of intussusception. Unreducible intussusception status post attempted radiographic reduction. Presented with history of vomiting hematechesia loss of appetite fever 100.4 plus. Reports currant jelly or blood stools present. Temp in ER 100.4 PE:WNL except for abdomen soft tenderness in periumbilical mild in intensity. Mass soft mobile mass approximately 5cm in diameter to right below of umbilicus, hypoactive bowel sounds. Rectal exam shows empty vault.
Vaccinated: | 2006-12-08 |
Onset: | 2007-01-26 |
Submitted: | 2007-01-31 |
Entered: | 2007-02-06 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B059AA / 2 | LL / IM |
PNC: PNEUMO (PREVNAR7) PNEUMO (PREVNAR) / LEDERLE LABORATORIES | B08658H / 2 | LL / IM |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0411F / 2 | - / PO |
Administered by: Public Purchased by: Public
Symptoms: Abdominal mass, Abdominal tenderness, Anorexia, Body temperature, Bowel sounds abnormal, Haematochezia, Intussusception, Laparotomy, Large intestinal obstruction reduction, Surgery, Vomiting, Abdominal X-ray
Life Threatening? Yes
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: 2
Write-up: Intussusception (6 weeks after 3rd dose of Rotavirus vaccine) requiring surgery. 02/16/07-Records reviewed for DOS 01/26-01/28/07- DC DX:Intussusception Surgical procedure:Laparotomy for manual reduction of intussusception. Unreducible intussusception status post attempted radiographic reduction. Presented with history of vomiting hematechesia loss of appetite fever 100.4 plus. Reports currant jelly or blood stools present. Temp in ER 100.4 PE:WNL except for abdomen soft tenderness in periumbilical mild in intensity. Mass soft mobile mass approximately 5cm in diameter to right below of umbilicus, hypoactive bowel sounds. Rectal exam shows empty vault.
Vaccinated: | 2006-12-08 |
Onset: | 2007-01-26 |
Submitted: | 2007-01-31 |
Entered: | 2007-02-06 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B059AA / 2 | LL / IM |
PNC: PNEUMO (PREVNAR) / LEDERLE LABORATORIES | B08658H / 2 | LL / IM |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0411F / 2 | - / PO |
Administered by: Public Purchased by: Public
Symptoms: Abdominal mass, Abdominal tenderness, Anorexia, Body temperature, Bowel sounds abnormal, Haematochezia, Intussusception, Laparotomy, Large intestinal obstruction reduction, Surgery, Vomiting, Abdominal X-ray
Life Threatening? Yes
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: 2
Write-up: Intussusception (6 weeks after 3rd dose of Rotavirus vaccine) requiring surgery. 02/16/07-Records reviewed for DOS 01/26-01/28/07- DC DX:Intussusception Surgical procedure:Laparotomy for manual reduction of intussusception. Unreducible intussusception status post attempted radiographic reduction. Presented with history of vomiting hematechesia loss of appetite fever 100.4 plus. Reports currant jelly or blood stools present. Temp in ER 100.4 PE:WNL except for abdomen soft tenderness in periumbilical mild in intensity. Mass soft mobile mass approximately 5cm in diameter to right below of umbilicus, hypoactive bowel sounds. Rectal exam shows empty vault.
Vaccinated: | 2006-12-08 |
Onset: | 2007-01-26 |
Submitted: | 2007-01-31 |
Entered: | 2007-02-06 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B059AA / 2 | LL / IM |
PNC: PNEUMO (PREVNAR) / LEDERLE LABORATORIES | B08658H / 2 | LL / IM |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0411F / 2 | - / PO |
Administered by: Public Purchased by: Public
Symptoms: Abdominal mass, Abdominal tenderness, Anorexia, Body temperature, Bowel sounds abnormal, Haematochezia, Intussusception, Laparotomy, Large intestinal obstruction reduction, Surgery, Vomiting, Abdominal X-ray
Life Threatening? Yes
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: 2
Write-up: Intussusception (6 weeks after 3rd dose of Rotavirus vaccine) requiring surgery. 02/16/07-Records reviewed for DOS 01/26-01/28/07- DC DX:Intussusception Surgical procedure:Laparotomy for manual reduction of intussusception. Unreducible intussusception status post attempted radiographic reduction. Presented with history of vomiting hematechesia loss of appetite fever 100.4 plus. Reports currant jelly or blood stools present. Temp in ER 100.4 PE:WNL except for abdomen soft tenderness in periumbilical mild in intensity. Mass soft mobile mass approximately 5cm in diameter to right below of umbilicus, hypoactive bowel sounds. Rectal exam shows empty vault.
Vaccinated: | 2006-12-08 |
Onset: | 2007-01-26 |
Submitted: | 2007-01-31 |
Entered: | 2007-02-06 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B059AA / 2 | LL / IM |
PNC: PNEUMO (PREVNAR) / LEDERLE LABORATORIES | B08658H / 2 | LL / IM |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0411F / 2 | - / PO |
Administered by: Public Purchased by: Public
Symptoms: Abdominal mass, Abdominal tenderness, Anorexia, Body temperature, Bowel sounds abnormal, Haematochezia, Intussusception, Laparotomy, Large intestinal obstruction reduction, Surgery, Vomiting, Abdominal X-ray
Life Threatening? Yes
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: 2
Write-up: Intussusception (6 weeks after 3rd dose of Rotavirus vaccine) requiring surgery. 02/16/07-Records reviewed for DOS 01/26-01/28/07- DC DX:Intussusception Surgical procedure:Laparotomy for manual reduction of intussusception. Unreducible intussusception status post attempted radiographic reduction. Presented with history of vomiting hematechesia loss of appetite fever 100.4 plus. Reports currant jelly or blood stools present. Temp in ER 100.4 PE:WNL except for abdomen soft tenderness in periumbilical mild in intensity. Mass soft mobile mass approximately 5cm in diameter to right below of umbilicus, hypoactive bowel sounds. Rectal exam shows empty vault.
Vaccinated: | 2006-12-08 |
Onset: | 2007-01-26 |
Submitted: | 2007-01-31 |
Entered: | 2007-02-06 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B059AA / 2 | LL / IM |
PNC: PNEUMO (PREVNAR) / LEDERLE LABORATORIES | B08658H / 2 | LL / IM |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0411F / 2 | - / PO |
Administered by: Public Purchased by: Public
Symptoms: Abdominal mass, Abdominal tenderness, Anorexia, Body temperature, Bowel sounds abnormal, Haematochezia, Intussusception, Laparotomy, Large intestinal obstruction reduction, Surgery, Vomiting, Abdominal X-ray
Life Threatening? Yes
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: 2
Write-up: Intussusception (6 weeks after 3rd dose of Rotavirus vaccine) requiring surgery. 02/16/07-Records reviewed for DOS 01/26-01/28/07- DC DX:Intussusception Surgical procedure:Laparotomy for manual reduction of intussusception. Unreducible intussusception status post attempted radiographic reduction. Presented with history of vomiting hematechesia loss of appetite fever 100.4 plus. Reports currant jelly or blood stools present. Temp in ER 100.4 PE:WNL except for abdomen soft tenderness in periumbilical mild in intensity. Mass soft mobile mass approximately 5cm in diameter to right below of umbilicus, hypoactive bowel sounds. Rectal exam shows empty vault.
Vaccinated: | 2006-12-08 |
Onset: | 2007-01-26 |
Submitted: | 2007-01-31 |
Entered: | 2007-02-06 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B059AA / 2 | LL / IM |
PNC: PNEUMO (PREVNAR) / LEDERLE LABORATORIES | B08658H / 2 | LL / IM |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0411F / 2 | - / PO |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0411F / 2 | - / PO |
Administered by: Public Purchased by: Public
Symptoms: Abdominal mass, Abdominal tenderness, Anorexia, Body temperature, Bowel sounds abnormal, Haematochezia, Intussusception, Laparotomy, Large intestinal obstruction reduction, Surgery, Vomiting, Abdominal X-ray
Life Threatening? Yes
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: 2
Write-up: Intussusception (6 weeks after 3rd dose of Rotavirus vaccine) requiring surgery. 02/16/07-Records reviewed for DOS 01/26-01/28/07- DC DX:Intussusception Surgical procedure:Laparotomy for manual reduction of intussusception. Unreducible intussusception status post attempted radiographic reduction. Presented with history of vomiting hematechesia loss of appetite fever 100.4 plus. Reports currant jelly or blood stools present. Temp in ER 100.4 PE:WNL except for abdomen soft tenderness in periumbilical mild in intensity. Mass soft mobile mass approximately 5cm in diameter to right below of umbilicus, hypoactive bowel sounds. Rectal exam shows empty vault.
Vaccinated: | 2006-12-08 |
Onset: | 2007-01-26 |
Submitted: | 2007-01-31 |
Entered: | 2007-02-06 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B059AA / 2 | LL / IM |
PNC: PNEUMO (PREVNAR) / LEDERLE LABORATORIES | B08658H / 2 | LL / IM |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0411F / 2 | - / PO |
Administered by: Public Purchased by: Public
Symptoms: Abdominal mass, Abdominal tenderness, Anorexia, Body temperature, Bowel sounds abnormal, Haematochezia, Intussusception, Laparotomy, Large intestinal obstruction reduction, Surgery, Vomiting, Abdominal X-ray
Life Threatening? Yes
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: 2
Write-up: Intussusception (6 weeks after 3rd dose of Rotavirus vaccine) requiring surgery. 02/16/07-Records reviewed for DOS 01/26-01/28/07- DC DX:Intussusception Surgical procedure:Laparotomy for manual reduction of intussusception. Unreducible intussusception status post attempted radiographic reduction. Presented with history of vomiting hematechesia loss of appetite fever 100.4 plus. Reports currant jelly or blood stools present. Temp in ER 100.4 PE:WNL except for abdomen soft tenderness in periumbilical mild in intensity. Mass soft mobile mass approximately 5cm in diameter to right below of umbilicus, hypoactive bowel sounds. Rectal exam shows empty vault.
Vaccinated: | 2006-12-08 |
Onset: | 2007-01-26 |
Submitted: | 2007-01-31 |
Entered: | 2007-02-06 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B059AA / 2 | LL / IM |
PNC: PNEUMO (PREVNAR) / LEDERLE LABORATORIES PFIZER/WYETH | B08658H / 2 | LL / IM |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0411F / 2 | - / PO |
Administered by: Public Purchased by: Public
Symptoms: Abdominal mass, Abdominal tenderness, Anorexia, Body temperature, Bowel sounds abnormal, Haematochezia, Intussusception, Laparotomy, Large intestinal obstruction reduction, Surgery, Vomiting, Abdominal X-ray
Life Threatening? Yes
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: 2
Write-up: Intussusception (6 weeks after 3rd dose of Rotavirus vaccine) requiring surgery. 02/16/07-Records reviewed for DOS 01/26-01/28/07- DC DX:Intussusception Surgical procedure:Laparotomy for manual reduction of intussusception. Unreducible intussusception status post attempted radiographic reduction. Presented with history of vomiting hematechesia loss of appetite fever 100.4 plus. Reports currant jelly or blood stools present. Temp in ER 100.4 PE:WNL except for abdomen soft tenderness in periumbilical mild in intensity. Mass soft mobile mass approximately 5cm in diameter to right below of umbilicus, hypoactive bowel sounds. Rectal exam shows empty vault.
Vaccinated: | 2006-12-08 |
Onset: | 2007-01-26 |
Submitted: | 2007-01-31 |
Entered: | 2007-02-06 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B059AA / 2 3 | LL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B08658H / 2 3 | LL / IM |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0411F / 2 3 | - MO / PO |
Administered by: Public Purchased by: Public
Symptoms: Intussusception, Surgery
Life Threatening? Yes
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: 2
Write-up: Intussusception (6 weeks after 3rd dose of Rotavirus vaccine) requiring surgery. 02/16/07-Records reviewed for DOS 01/26-01/28/07- DC DX:Intussusception Surgical procedure:Laparotomy for manual reduction of intussusception. Unreducible intussusception status post attempted radiographic reduction. Presented with history of vomiting hematechesia loss of appetite fever 100.4 plus. Reports currant jelly or blood stools present. Temp in ER 100.4 PE:WNL except for abdomen soft tenderness in periumbilical mild in intensity. Mass soft mobile mass approximately 5cm in diameter to right below of umbilicus, hypoactive bowel sounds. Rectal exam shows empty vault.
Vaccinated: | 2006-12-08 |
Onset: | 2007-01-26 |
Submitted: | 2007-01-31 |
Entered: | 2007-02-06 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B059AA / 3 | LL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B08658H / 3 | LL / IM |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0411F / 3 | MO / PO |
Administered by: Public Purchased by: Public
Symptoms: Intussusception, Surgery
Life Threatening? Yes
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: 2
Write-up: Intussusception (6 weeks after 3rd dose of Rotavirus vaccine) requiring surgery. 02/16/07-Records reviewed for DOS 01/26-01/28/07- DC DX:Intussusception Surgical procedure:Laparotomy for manual reduction of intussusception. Unreducible intussusception status post attempted radiographic reduction. Presented with history of vomiting hematechesia loss of appetite fever 100.4 plus. Reports currant jelly or blood stools present. Temp in ER 100.4 PE:WNL except for abdomen soft tenderness in periumbilical mild in intensity. Mass soft mobile mass approximately 5cm in diameter to right below of umbilicus, hypoactive bowel sounds. Rectal exam shows empty vault.
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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=271803&WAYBACKHISTORY=ON
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