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This is VAERS ID 273097

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

273097
VAERS Form:
Age:
Gender:Unknown
Location:Unknown
Vaccinated:2006-10-30
Onset:2006-12-10
Submitted:2007-02-26
Entered:2007-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / - - / PO

Administered by: Other      Purchased by: Unknown
Symptoms: Intussusception

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

Write-up:Information has been received from a physician concerning a patient who on approximately 30-OCT-2006 was vaccinated with an oral dose of Rotateq. On 10-DEC-2006 the patient was referred to the hospital for intussusception. The patients outcome was not kno"wn. There was no product quality complaint involved. The patient''''s intussusception was considered to be life threatening. Additional information has been requested.


Changed on 12/8/2009

273097 Before After
VAERS Form:
Age:
Gender:Unknown
Location:Unknown
Vaccinated:2006-10-30
Onset:2006-12-10
Submitted:2007-02-26
Entered:2007-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / - - / PO

Administered by: Other      Purchased by: Unknown Other
Symptoms: Intussusception

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0702USA03466

Write-up:Information has been received from a physician concerning a patient who on approximately 30-OCT-2006 was vaccinated with an oral dose of Rotateq. On 10-DEC-2006 the patient was referred to the hospital for intussusception. The patients outcome was not kno"wn. known. There was no product quality complaint involved. The patient''''s patient''s intussusception was considered to be life threatening. Additional information has been requested.


Changed on 1/5/2010

273097 Before After
VAERS Form:
Age:(blank) 0.4
Gender:Unknown
Location:Unknown
Vaccinated:2006-10-30
Onset:2006-12-10
Submitted:2007-02-26
Entered:2007-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - 0778F / - - / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 0 (blank)     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0702USA03466

Write-up:Information has been received from a physician concerning a patient who on approximately 30-OCT-2006 was vaccinated with an oral dose of Rotateq. On 10-DEC-2006 the patient was referred to the hospital for intussusception. The patients outcome was not known. There was no product quality complaint involved. The patient''s intussusception was considered to be life threatening. Additional information has been requested.


Changed on 5/13/2013

273097 Before After
VAERS Form:
Age:0.4
Gender:Unknown
Location:Unknown
Vaccinated:2006-10-30
Onset:2006-12-10
Submitted:2007-02-26
Entered:2007-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0778F / - - / PO
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0778F / - - / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0702USA03466

Write-up:Information has been received from a physician concerning a patient who on approximately 30-OCT-2006 was vaccinated with an oral dose of Rotateq. On 10-DEC-2006 the patient was referred to the hospital for intussusception. The patients outcome was not known. There was no product quality complaint involved. The patient''s intussusception was considered to be life threatening. Additional information has been requested.


Changed on 6/14/2014

273097 Before After
VAERS Form:
Age:0.4
Gender:Unknown
Location:Unknown
Vaccinated:2006-10-30
Onset:2006-12-10
Submitted:2007-02-26
Entered:2007-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0778F / - - / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0702USA03466

Write-up:Information has been received from a physician concerning a patient who on approximately 30-OCT-2006 was vaccinated with an oral dose of Rotateq. On 10-DEC-2006 the patient was referred to the hospital for intussusception. The patients outcome was not known. There was no product quality complaint involved. The patient''s intussusception was considered to be life threatening. Additional information has been requested.


Changed on 2/14/2017

273097 Before After
VAERS Form:
Age:0.4 0.36
Gender:Unknown
Location:Unknown
Vaccinated:2006-10-30
Onset:2006-12-10
Submitted:2007-02-26
Entered:2007-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0778F / - - / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0702USA03466

Write-up:Information has been received from a physician concerning a patient who on approximately 30-OCT-2006 was vaccinated with an oral dose of Rotateq. On 10-DEC-2006 the patient was referred to the hospital for intussusception. The patients outcome was not known. There was no product quality complaint involved. The patient''s intussusception was considered to be life threatening. Additional information has been requested.


Changed on 5/14/2017

273097 Before After
VAERS Form:
Age:0.36
Gender:Unknown
Location:Unknown
Vaccinated:2006-10-30
Onset:2006-12-10
Submitted:2007-02-26
Entered:2007-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0778F / - - / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0702USA03466

Write-up:Information has been received from a physician concerning a patient who on approximately 30-OCT-2006 was vaccinated with an oral dose of Rotateq. On 10-DEC-2006 the patient was referred to the hospital for intussusception. The patients outcome was not known. There was no product quality complaint involved. The patient''s intussusception was considered to be life threatening. Additional information has been requested.


Changed on 9/14/2017

273097 Before After
VAERS Form:(blank) 1
Age:0.36
Gender:Unknown
Location:Unknown
Vaccinated:2006-10-30
Onset:2006-12-10
Submitted:2007-02-26
Entered:2007-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0778F / - UNK - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0702USA03466

Write-up:Information has been received from a physician concerning a patient who on approximately 30-OCT-2006 was vaccinated with an oral dose of Rotateq. On 10-DEC-2006 the patient was referred to the hospital for intussusception. The patients outcome was not known. There was no product quality complaint involved. The patient''s intussusception was considered to be life threatening. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=273097&WAYBACKHISTORY=ON


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