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This is VAERS ID 274937

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 274937
VAERS Form:
Age:0.5
Gender:Female
Location:Unknown
Vaccinated:2007-01-31
Onset:2007-02-27
Submitted:2007-03-26
Entered:2007-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1232F / 2 - / PO

Administered by: Other      Purchased by: Unknown
Symptoms: Abdominal rigidity, Anion gap increased, Barium enema, Blood calcium increased, Abdominal X-ray

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? Yes
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 6 month old female who on 31-JAN-2007 was vaccinated with her last dose of Rotateq (lot #654970/0777F) (the dated of the other two doses were not reported). The patient had no medical history or"concomitant therapy. On 27-FEB-2007, the patient was examined by the physician and had developed intussusception. The patient''''s symptoms at the time of the exam were reported as unknown. On 01-MAR-2007, the patient was hospitalized for intussusception. A


Changed on 12/8/2009

VAERS ID: 274937 Before After
VAERS Form:
Age:0.5
Gender:Female
Location:Unknown
Vaccinated:2007-01-31
Onset:2007-02-27
Submitted:2007-03-26
Entered:2007-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1232F / 2 - / PO

Administered by: Other      Purchased by: Unknown Other
Symptoms: Abdominal rigidity, Anion gap increased, Barium enema, Blood calcium increased, Blood chloride decreased, Blood creatinine decreased, Bowel sounds abnormal, Dehydration, Haematochezia, Haematocrit decreased, Haemoglobin decreased, Ileus, Intussusception, Lethargy, Lymphocyte count decreased, Monocyte count decreased, Neutrophil count increased, Pyrexia, Small intestinal obstruction, Small intestinal resection, Specific gravity urine abnormal, Surgery, Tachycardia, Vomiting, Enema administration, Platelet count increased, Ultrasound abdomen abnormal, Intestinal resection, Intestinal anastomosis, Urine ketone body present, Abdominal X-ray

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK LABS: abdominal x-ray revealed SBO. Barium enema revealed IS in mid transverse colon, not completely reduced. US of abdomen + for IS. H/H 10.1/29.0, plts 485, neutros 52.2, lymphs 44.8, monos 2.6. Cl 97, anion gap 19, ca 10.7, crea
CDC 'Split Type': (blank) WAES0703USA04304

Write-up: Information has been received from a physician concerning a 6 month old female who on 31-JAN-2007 was vaccinated with her last dose of Rotateq (lot #654970/0777F) (the dated of the other two doses were not reported). The patient had no medical history or"concomitant or concomitant therapy. On 27-FEB-2007, the patient was examined by the physician and had developed intussusception. The patient''''s patient''s symptoms at the time of the exam were reported as unknown. On 01-MAR-2007, the patient was hospitalized for intussusception. A An enema reduction was attempted unsuccessfully. The patient had bowel resection surgery. On an unspecified date, the patient recovered from intussusception. Her release date from the hospital was not known. The physician considered intussusception to be immediately life-threatening, and disabling, and an other important medical event. There was no product quality complaint involved. Additional information has been requested. 4/13/07 Received medical records & vax records from PCP which reveal child was in good health on day of vax 1/31/07. Growth & development were as expected for age. Lot # for 3rd dose of Rotateq incorrect on VAERS report & corrected in database. 4/27/07 Received medical records from hospital which reveal patient experienced bilious vomiting, lethargy, fever & dehydration x 2 days prior to admit on 3/1/07-3/5/07. Exam revealed tachycardia, decreased bowel sounds & guarding. Rad attempts at reducing IS were unsuccessful & taken to OR for exp lap, reduction of IS & small bowel resection w/primary anastomosis. Developed post op ileus which resolved. Slowed advanced diet & had maroon stools initially. D/c to home. FINAL DX: ileoileal intussusception, surgically reduced & small bowel resection.


Changed on 8/31/2010

VAERS ID: 274937 Before After
VAERS Form:
Age:0.5
Gender:Female
Location:Unknown
Vaccinated:2007-01-31
Onset:2007-02-27
Submitted:2007-03-26
Entered:2007-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1232F / 2 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal rigidity, Anion gap increased, Barium enema, Blood calcium increased, Blood chloride decreased, Blood creatinine decreased, Bowel sounds abnormal, Dehydration, Haematochezia, Haematocrit decreased, Haemoglobin decreased, Ileus, Intussusception, Lethargy, Lymphocyte count decreased, Monocyte count decreased, Neutrophil count increased, Pyrexia, Small intestinal obstruction, Small intestinal resection, Specific gravity urine abnormal, Surgery, Tachycardia, Vomiting, Enema administration, Platelet count increased, Ultrasound abdomen abnormal, Intestinal resection, Intestinal anastomosis, Urine ketone body present, Abdominal X-ray

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK LABS: abdominal x-ray revealed SBO. Barium enema revealed IS in mid transverse colon, not completely reduced. US of abdomen + for IS. H/H 10.1/29.0, plts 485, neutros 52.2, lymphs 44.8, monos 2.6. Cl 97, anion gap 19, ca 10.7, crea
CDC 'Split Type': WAES0703USA04304

Write-up: Information has been received from a physician concerning a 6 month old female who on 31-JAN-2007 was vaccinated with her last dose of Rotateq (lot #654970/0777F) (the dated of the other two doses were not reported). The patient had no medical history or concomitant therapy. On 27-FEB-2007, the patient was examined by the physician and had developed intussusception. The patient''s symptoms at the time of the exam were reported as unknown. On 01-MAR-2007, the patient was hospitalized for intussusception. An enema reduction was attempted unsuccessfully. The patient had bowel resection surgery. On an unspecified date, the patient recovered from intussusception. Her release date from the hospital was not known. The physician considered intussusception to be immediately life-threatening, and disabling, and an other important medical event. There was no product quality complaint involved. Additional information has been requested. 4/13/07 Received medical records & vax records from PCP which reveal child was in good health on day of vax 1/31/07. Growth & development were as expected for age. Lot # for 3rd dose of Rotateq incorrect on VAERS report & corrected in database. 4/27/07 Received medical records from hospital which reveal patient experienced bilious vomiting, lethargy, fever & dehydration x 2 days prior to admit on 3/1/07-3/5/07. Exam revealed tachycardia, decreased bowel sounds & guarding. Rad attempts at reducing IS were unsuccessful & taken to OR for exp lap, reduction of IS & small bowel resection w/primary anastomosis. Developed post op ileus which resolved. Slowed advanced diet & had maroon stools initially. D/c to home. FINAL DX: ileoileal intussusception, surgically reduced & small bowel resection.


Changed on 4/13/2011

VAERS ID: 274937 Before After
VAERS Form:
Age:0.5
Gender:Female
Location:Unknown
Vaccinated:2007-01-31
Onset:2007-02-27
Submitted:2007-03-26
Entered:2007-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1232F / 2 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal rigidity, Anion gap increased, Barium enema, Blood calcium increased, Blood chloride decreased, Blood creatinine decreased, Bowel sounds abnormal, Dehydration, Haematochezia, Haematocrit decreased, Haemoglobin decreased, Ileus, Intussusception, Lethargy, Lymphocyte count decreased, Monocyte count decreased, Neutrophil count increased, Pyrexia, Small intestinal obstruction, Small intestinal resection, Specific gravity urine abnormal, Surgery, Tachycardia, Vomiting, Enema administration, Platelet count increased, Ultrasound abdomen abnormal, Intestinal resection, Intestinal anastomosis, Urine ketone body present, Abdominal X-ray

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK LABS: abdominal x-ray revealed SBO. Barium enema revealed IS in mid transverse colon, not completely reduced. US of abdomen + for IS. H/H 10.1/29.0, plts 485, neutros 52.2, lymphs 44.8, monos 2.6. Cl 97, anion gap 19, ca 10.7, crea
CDC 'Split Type': WAES0703USA04304

Write-up: Information has been received from a physician concerning a 6 month old female who on 31-JAN-2007 was vaccinated with her last dose of Rotateq (lot #654970/0777F) (the dated of the other two doses were not reported). The patient had no medical history or concomitant therapy. On 27-FEB-2007, the patient was examined by the physician and had developed intussusception. The patient''s symptoms at the time of the exam were reported as unknown. On 01-MAR-2007, the patient was hospitalized for intussusception. An enema reduction was attempted unsuccessfully. The patient had bowel resection surgery. On an unspecified date, the patient recovered from intussusception. Her release date from the hospital was not known. The physician considered intussusception to be immediately life-threatening, and disabling, and an other important medical event. There was no product quality complaint involved. Additional information has been requested. 4/13/07 Received medical records & vax records from PCP which reveal child was in good health on day of vax 1/31/07. Growth & development were as expected for age. Lot # for 3rd dose of Rotateq incorrect on VAERS report & corrected in database. 4/27/07 Received medical records from hospital which reveal patient experienced bilious vomiting, lethargy, fever & dehydration x 2 days prior to admit on 3/1/07-3/5/07. Exam revealed tachycardia, decreased bowel sounds & guarding. Rad attempts at reducing IS were unsuccessful & taken to OR for exp lap, reduction of IS & small bowel resection w/primary anastomosis. Developed post op ileus which resolved. Slowed advanced diet & had maroon stools initially. D/c to home. FINAL DX: ileoileal intussusception, surgically reduced & small bowel resection.


Changed on 5/13/2011

VAERS ID: 274937 Before After
VAERS Form:
Age:0.5
Gender:Female
Location:Unknown
Vaccinated:2007-01-31
Onset:2007-02-27
Submitted:2007-03-26
Entered:2007-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1232F / 2 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal rigidity, Anion gap increased, Barium enema, Blood calcium increased, Blood chloride decreased, Blood creatinine decreased, Bowel sounds abnormal, Dehydration, Haematochezia, Haematocrit decreased, Haemoglobin decreased, Ileus, Intussusception, Lethargy, Lymphocyte count decreased, Monocyte count decreased, Neutrophil count increased, Pyrexia, Small intestinal obstruction, Small intestinal resection, Specific gravity urine abnormal, Surgery, Tachycardia, Vomiting, Enema administration, Platelet count increased, Ultrasound abdomen abnormal, Intestinal resection, Intestinal anastomosis, Urine ketone body present, Abdominal X-ray

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK LABS: abdominal x-ray revealed SBO. Barium enema revealed IS in mid transverse colon, not completely reduced. US of abdomen + for IS. H/H 10.1/29.0, plts 485, neutros 52.2, lymphs 44.8, monos 2.6. Cl 97, anion gap 19, ca 10.7, crea
CDC 'Split Type': WAES0703USA04304

Write-up: Information has been received from a physician concerning a 6 month old female who on 31-JAN-2007 was vaccinated with her last dose of Rotateq (lot #654970/0777F) (the dated of the other two doses were not reported). The patient had no medical history or concomitant therapy. On 27-FEB-2007, the patient was examined by the physician and had developed intussusception. The patient''s symptoms at the time of the exam were reported as unknown. On 01-MAR-2007, the patient was hospitalized for intussusception. An enema reduction was attempted unsuccessfully. The patient had bowel resection surgery. On an unspecified date, the patient recovered from intussusception. Her release date from the hospital was not known. The physician considered intussusception to be immediately life-threatening, and disabling, and an other important medical event. There was no product quality complaint involved. Additional information has been requested. 4/13/07 Received medical records & vax records from PCP which reveal child was in good health on day of vax 1/31/07. Growth & development were as expected for age. Lot # for 3rd dose of Rotateq incorrect on VAERS report & corrected in database. 4/27/07 Received medical records from hospital which reveal patient experienced bilious vomiting, lethargy, fever & dehydration x 2 days prior to admit on 3/1/07-3/5/07. Exam revealed tachycardia, decreased bowel sounds & guarding. Rad attempts at reducing IS were unsuccessful & taken to OR for exp lap, reduction of IS & small bowel resection w/primary anastomosis. Developed post op ileus which resolved. Slowed advanced diet & had maroon stools initially. D/c to home. FINAL DX: ileoileal intussusception, surgically reduced & small bowel resection.


Changed on 6/11/2011

VAERS ID: 274937 Before After
VAERS Form:
Age:0.5
Gender:Female
Location:Unknown
Vaccinated:2007-01-31
Onset:2007-02-27
Submitted:2007-03-26
Entered:2007-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1232F / 2 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal rigidity, Anion gap increased, Barium enema, Blood calcium increased, Blood chloride decreased, Blood creatinine decreased, Bowel sounds abnormal, Dehydration, Haematochezia, Haematocrit decreased, Haemoglobin decreased, Ileus, Intussusception, Lethargy, Lymphocyte count decreased, Monocyte count decreased, Neutrophil count increased, Pyrexia, Small intestinal obstruction, Small intestinal resection, Specific gravity urine abnormal, Surgery, Tachycardia, Vomiting, Enema administration, Platelet count increased, Ultrasound abdomen abnormal, Intestinal resection, Intestinal anastomosis, Urine ketone body present, Abdominal X-ray

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK LABS: abdominal x-ray revealed SBO. Barium enema revealed IS in mid transverse colon, not completely reduced. US of abdomen + for IS. H/H 10.1/29.0, plts 485, neutros 52.2, lymphs 44.8, monos 2.6. Cl 97, anion gap 19, ca 10.7, crea
CDC 'Split Type': WAES0703USA04304

Write-up: Information has been received from a physician concerning a 6 month old female who on 31-JAN-2007 was vaccinated with her last dose of Rotateq (lot #654970/0777F) (the dated of the other two doses were not reported). The patient had no medical history or concomitant therapy. On 27-FEB-2007, the patient was examined by the physician and had developed intussusception. The patient''s symptoms at the time of the exam were reported as unknown. On 01-MAR-2007, the patient was hospitalized for intussusception. An enema reduction was attempted unsuccessfully. The patient had bowel resection surgery. On an unspecified date, the patient recovered from intussusception. Her release date from the hospital was not known. The physician considered intussusception to be immediately life-threatening, and disabling, and an other important medical event. There was no product quality complaint involved. Additional information has been requested. 4/13/07 Received medical records & vax records from PCP which reveal child was in good health on day of vax 1/31/07. Growth & development were as expected for age. Lot # for 3rd dose of Rotateq incorrect on VAERS report & corrected in database. 4/27/07 Received medical records from hospital which reveal patient experienced bilious vomiting, lethargy, fever & dehydration x 2 days prior to admit on 3/1/07-3/5/07. Exam revealed tachycardia, decreased bowel sounds & guarding. Rad attempts at reducing IS were unsuccessful & taken to OR for exp lap, reduction of IS & small bowel resection w/primary anastomosis. Developed post op ileus which resolved. Slowed advanced diet & had maroon stools initially. D/c to home. FINAL DX: ileoileal intussusception, surgically reduced & small bowel resection.


Changed on 2/13/2013

VAERS ID: 274937 Before After
VAERS Form:
Age:0.5
Gender:Female
Location:Unknown
Vaccinated:2007-01-31
Onset:2007-02-27
Submitted:2007-03-26
Entered:2007-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1232F / 2 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal rigidity, Anion gap increased, Barium enema, Blood calcium increased, Blood chloride decreased, Blood creatinine decreased, Bowel sounds abnormal, Dehydration, Haematochezia, Haematocrit decreased, Haemoglobin decreased, Ileus, Intussusception, Lethargy, Lymphocyte count decreased, Monocyte count decreased, Neutrophil count increased, Pyrexia, Small intestinal obstruction, Small intestinal resection, Specific gravity urine abnormal, Surgery, Tachycardia, Vomiting, Enema administration, Platelet count increased, Ultrasound abdomen abnormal, Intestinal resection, Intestinal anastomosis, Urine ketone body present, Abdominal X-ray

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK LABS: abdominal x-ray revealed SBO. Barium enema revealed IS in mid transverse colon, not completely reduced. US of abdomen + for IS. H/H 10.1/29.0, plts 485, neutros 52.2, lymphs 44.8, monos 2.6. Cl 97, anion gap 19, ca 10.7, crea creatinine 0.3. Urine sp grav 1.034, ketones 3+
CDC 'Split Type': WAES0703USA04304

Write-up: Information has been received from a physician concerning a 6 month old female who on 31-JAN-2007 was vaccinated with her last dose of Rotateq (lot #654970/0777F) (the dated of the other two doses were not reported). The patient had no medical history or concomitant therapy. On 27-FEB-2007, the patient was examined by the physician and had developed intussusception. The patient''s symptoms at the time of the exam were reported as unknown. On 01-MAR-2007, the patient was hospitalized for intussusception. An enema reduction was attempted unsuccessfully. The patient had bowel resection surgery. On an unspecified date, the patient recovered from intussusception. Her release date from the hospital was not known. The physician considered intussusception to be immediately life-threatening, and disabling, and an other important medical event. There was no product quality complaint involved. Additional information has been requested. 4/13/07 Received medical records & vax records from PCP which reveal child was in good health on day of vax 1/31/07. Growth & development were as expected for age. Lot # for 3rd dose of Rotateq incorrect on VAERS report & corrected in database. 4/27/07 Received medical records from hospital which reveal patient experienced bilious vomiting, lethargy, fever & dehydration x 2 days prior to admit on 3/1/07-3/5/07. Exam revealed tachycardia, decreased bowel sounds & guarding. Rad attempts at reducing IS were unsuccessful & taken to OR for exp lap, reduction of IS & small bowel resection w/primary anastomosis. Developed post op ileus which resolved. Slowed advanced diet & had maroon stools initially. D/c to home. FINAL DX: ileoileal intussusception, surgically reduced & small bowel resection.


Changed on 5/13/2013

VAERS ID: 274937 Before After
VAERS Form:
Age:0.5
Gender:Female
Location:Unknown
Vaccinated:2007-01-31
Onset:2007-02-27
Submitted:2007-03-26
Entered:2007-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1232F / 2 - / PO
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1232F / 2 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal rigidity, Anion gap increased, Barium enema, Blood calcium increased, Blood chloride decreased, Blood creatinine decreased, Bowel sounds abnormal, Dehydration, Haematochezia, Haematocrit decreased, Haemoglobin decreased, Ileus, Intussusception, Lethargy, Lymphocyte count decreased, Monocyte count decreased, Neutrophil count increased, Pyrexia, Small intestinal obstruction, Small intestinal resection, Specific gravity urine abnormal, Surgery, Tachycardia, Vomiting, Enema administration, Platelet count increased, Ultrasound abdomen abnormal, Intestinal resection, Intestinal anastomosis, Urine ketone body present, Abdominal X-ray

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK LABS: abdominal x-ray revealed SBO. Barium enema revealed IS in mid transverse colon, not completely reduced. US of abdomen + for IS. H/H 10.1/29.0, plts 485, neutros 52.2, lymphs 44.8, monos 2.6. Cl 97, anion gap 19, ca 10.7, creatinine 0.3. Urine sp grav 1.034, ketones 3+
CDC 'Split Type': WAES0703USA04304

Write-up: Information has been received from a physician concerning a 6 month old female who on 31-JAN-2007 was vaccinated with her last dose of Rotateq (lot #654970/0777F) (the dated of the other two doses were not reported). The patient had no medical history or concomitant therapy. On 27-FEB-2007, the patient was examined by the physician and had developed intussusception. The patient''s symptoms at the time of the exam were reported as unknown. On 01-MAR-2007, the patient was hospitalized for intussusception. An enema reduction was attempted unsuccessfully. The patient had bowel resection surgery. On an unspecified date, the patient recovered from intussusception. Her release date from the hospital was not known. The physician considered intussusception to be immediately life-threatening, and disabling, and an other important medical event. There was no product quality complaint involved. Additional information has been requested. 4/13/07 Received medical records & vax records from PCP which reveal child was in good health on day of vax 1/31/07. Growth & development were as expected for age. Lot # for 3rd dose of Rotateq incorrect on VAERS report & corrected in database. 4/27/07 Received medical records from hospital which reveal patient experienced bilious vomiting, lethargy, fever & dehydration x 2 days prior to admit on 3/1/07-3/5/07. Exam revealed tachycardia, decreased bowel sounds & guarding. Rad attempts at reducing IS were unsuccessful & taken to OR for exp lap, reduction of IS & small bowel resection w/primary anastomosis. Developed post op ileus which resolved. Slowed advanced diet & had maroon stools initially. D/c to home. FINAL DX: ileoileal intussusception, surgically reduced & small bowel resection.


Changed on 6/14/2014

VAERS ID: 274937 Before After
VAERS Form:
Age:0.5
Gender:Female
Location:Unknown
Vaccinated:2007-01-31
Onset:2007-02-27
Submitted:2007-03-26
Entered:2007-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1232F / 2 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal rigidity, Anion gap increased, Barium enema, Blood calcium increased, Blood chloride decreased, Blood creatinine decreased, Bowel sounds abnormal, Dehydration, Haematochezia, Haematocrit decreased, Haemoglobin decreased, Ileus, Intussusception, Lethargy, Lymphocyte count decreased, Monocyte count decreased, Neutrophil count increased, Pyrexia, Small intestinal obstruction, Small intestinal resection, Specific gravity urine abnormal, Surgery, Tachycardia, Vomiting, Enema administration, Platelet count increased, Ultrasound abdomen abnormal, Intestinal resection, Intestinal anastomosis, Urine ketone body present, Abdominal X-ray

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK LABS: abdominal x-ray revealed SBO. Barium enema revealed IS in mid transverse colon, not completely reduced. US of abdomen + for IS. H/H 10.1/29.0, plts 485, neutros 52.2, lymphs 44.8, monos 2.6. Cl 97, anion gap 19, ca 10.7, creatinine 0.3. Urine sp grav 1.034, ketones 3+
CDC 'Split Type': WAES0703USA04304

Write-up: Information has been received from a physician concerning a 6 month old female who on 31-JAN-2007 was vaccinated with her last dose of Rotateq (lot #654970/0777F) (the dated of the other two doses were not reported). The patient had no medical history or concomitant therapy. On 27-FEB-2007, the patient was examined by the physician and had developed intussusception. The patient''s symptoms at the time of the exam were reported as unknown. On 01-MAR-2007, the patient was hospitalized for intussusception. An enema reduction was attempted unsuccessfully. The patient had bowel resection surgery. On an unspecified date, the patient recovered from intussusception. Her release date from the hospital was not known. The physician considered intussusception to be immediately life-threatening, and disabling, and an other important medical event. There was no product quality complaint involved. Additional information has been requested. 4/13/07 Received medical records & vax records from PCP which reveal child was in good health on day of vax 1/31/07. Growth & development were as expected for age. Lot # for 3rd dose of Rotateq incorrect on VAERS report & corrected in database. 4/27/07 Received medical records from hospital which reveal patient experienced bilious vomiting, lethargy, fever & dehydration x 2 days prior to admit on 3/1/07-3/5/07. Exam revealed tachycardia, decreased bowel sounds & guarding. Rad attempts at reducing IS were unsuccessful & taken to OR for exp lap, reduction of IS & small bowel resection w/primary anastomosis. Developed post op ileus which resolved. Slowed advanced diet & had maroon stools initially. D/c to home. FINAL DX: ileoileal intussusception, surgically reduced & small bowel resection.


Changed on 3/14/2015

VAERS ID: 274937 Before After
VAERS Form:
Age:0.5
Gender:Female
Location:Unknown
Vaccinated:2007-01-31
Onset:2007-02-27
Submitted:2007-03-26
Entered:2007-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1232F / 2 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal rigidity, Anion gap increased, Barium enema, Blood calcium increased, Blood chloride decreased, Blood creatinine decreased, Bowel sounds abnormal, Dehydration, Haematochezia, Haematocrit decreased, Haemoglobin decreased, Ileus, Intussusception, Lethargy, Lymphocyte count decreased, Monocyte count decreased, Neutrophil count increased, Pyrexia, Small intestinal obstruction, Small intestinal resection, Specific gravity urine abnormal, Surgery, Tachycardia, Vomiting, Enema administration, Platelet count increased, Ultrasound abdomen abnormal, Intestinal resection, Intestinal anastomosis, Urine ketone body present, Abdominal X-ray

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK LABS: abdominal x-ray revealed SBO. Barium enema revealed IS in mid transverse colon, not completely reduced. US of abdomen + for IS. H/H 10.1/29.0, plts 485, neutros 52.2, lymphs 44.8, monos 2.6. Cl 97, anion gap 19, ca 10.7, creatinine 0.3. Urine sp grav 1.034, ketones 3+
CDC 'Split Type': WAES0703USA04304

Write-up: Information has been received from a physician concerning a 6 month old female who on 31-JAN-2007 was vaccinated with her last dose of Rotateq (lot #654970/0777F) (the dated of the other two doses were not reported). The patient had no medical history or concomitant therapy. On 27-FEB-2007, the patient was examined by the physician and had developed intussusception. The patient''s symptoms at the time of the exam were reported as unknown. On 01-MAR-2007, the patient was hospitalized for intussusception. An enema reduction was attempted unsuccessfully. The patient had bowel resection surgery. On an unspecified date, the patient recovered from intussusception. Her release date from the hospital was not known. The physician considered intussusception to be immediately life-threatening, and disabling, and an other important medical event. There was no product quality complaint involved. Additional information has been requested. 4/13/07 Received medical records & vax records from PCP which reveal child was in good health on day of vax 1/31/07. Growth & development were as expected for age. Lot # for 3rd dose of Rotateq incorrect on VAERS report & corrected in database. 4/27/07 Received medical records from hospital which reveal patient experienced bilious vomiting, lethargy, fever & dehydration x 2 days prior to admit on 3/1/07-3/5/07. Exam revealed tachycardia, decreased bowel sounds & guarding. Rad attempts at reducing IS were unsuccessful & taken to OR for exp lap, reduction of IS & small bowel resection w/primary anastomosis. Developed post op ileus which resolved. Slowed advanced diet & had maroon stools initially. D/c to home. FINAL DX: ileoileal intussusception, surgically reduced & small bowel resection.


Changed on 2/14/2017

VAERS ID: 274937 Before After
VAERS Form:
Age:0.5 0.51
Gender:Female
Location:Unknown
Vaccinated:2007-01-31
Onset:2007-02-27
Submitted:2007-03-26
Entered:2007-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1232F / 2 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal rigidity, Anion gap increased, Barium enema, Blood calcium increased, Blood chloride decreased, Blood creatinine decreased, Bowel sounds abnormal, Dehydration, Haematochezia, Haematocrit decreased, Haemoglobin decreased, Ileus, Intussusception, Lethargy, Lymphocyte count decreased, Monocyte count decreased, Neutrophil count increased, Pyrexia, Small intestinal obstruction, Small intestinal resection, Specific gravity urine abnormal, Surgery, Tachycardia, Vomiting, Enema administration, Platelet count increased, Ultrasound abdomen abnormal, Intestinal resection, Intestinal anastomosis, Urine ketone body present, Abdominal X-ray

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK LABS: abdominal x-ray revealed SBO. Barium enema revealed IS in mid transverse colon, not completely reduced. US of abdomen + for IS. H/H 10.1/29.0, plts 485, neutros 52.2, lymphs 44.8, monos 2.6. Cl 97, anion gap 19, ca 10.7, creatinine 0.3. Urine sp grav 1.034, ketones 3+
CDC 'Split Type': WAES0703USA04304

Write-up: Information has been received from a physician concerning a 6 month old female who on 31-JAN-2007 was vaccinated with her last dose of Rotateq (lot #654970/0777F) (the dated of the other two doses were not reported). The patient had no medical history or concomitant therapy. On 27-FEB-2007, the patient was examined by the physician and had developed intussusception. The patient''s symptoms at the time of the exam were reported as unknown. On 01-MAR-2007, the patient was hospitalized for intussusception. An enema reduction was attempted unsuccessfully. The patient had bowel resection surgery. On an unspecified date, the patient recovered from intussusception. Her release date from the hospital was not known. The physician considered intussusception to be immediately life-threatening, and disabling, and an other important medical event. There was no product quality complaint involved. Additional information has been requested. 4/13/07 Received medical records & vax records from PCP which reveal child was in good health on day of vax 1/31/07. Growth & development were as expected for age. Lot # for 3rd dose of Rotateq incorrect on VAERS report & corrected in database. 4/27/07 Received medical records from hospital which reveal patient experienced bilious vomiting, lethargy, fever & dehydration x 2 days prior to admit on 3/1/07-3/5/07. Exam revealed tachycardia, decreased bowel sounds & guarding. Rad attempts at reducing IS were unsuccessful & taken to OR for exp lap, reduction of IS & small bowel resection w/primary anastomosis. Developed post op ileus which resolved. Slowed advanced diet & had maroon stools initially. D/c to home. FINAL DX: ileoileal intussusception, surgically reduced & small bowel resection.


Changed on 9/14/2017

VAERS ID: 274937 Before After
VAERS Form:(blank) 1
Age:0.51
Gender:Female
Location:Unknown
Vaccinated:2007-01-31
Onset:2007-02-27
Submitted:2007-03-26
Entered:2007-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1232F / 2 3 - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Surgery, Enema administration, Intestinal resection

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK LABS: abdominal x-ray revealed SBO. Barium enema revealed IS in mid transverse colon, not completely reduced. US of abdomen + for IS. H/H 10.1/29.0, plts 485, neutros 52.2, lymphs 44.8, monos 2.6. Cl 97, anion gap 19, ca 10.7, creatinine 0.3. Urine sp grav 1.034, ketones 3+
CDC 'Split Type': WAES0703USA04304

Write-up: Information has been received from a physician concerning a 6 month old female who on 31-JAN-2007 was vaccinated with her last dose of Rotateq (lot #654970/0777F) (the dated of the other two doses were not reported). The patient had no medical history or concomitant therapy. On 27-FEB-2007, the patient was examined by the physician and had developed intussusception. The patient''s symptoms at the time of the exam were reported as unknown. On 01-MAR-2007, the patient was hospitalized for intussusception. An enema reduction was attempted unsuccessfully. The patient had bowel resection surgery. On an unspecified date, the patient recovered from intussusception. Her release date from the hospital was not known. The physician considered intussusception to be immediately life-threatening, and disabling, and an other important medical event. There was no product quality complaint involved. Additional information has been requested. 4/13/07 Received medical records & vax records from PCP which reveal child was in good health on day of vax 1/31/07. Growth & development were as expected for age. Lot # for 3rd dose of Rotateq incorrect on VAERS report & corrected in database. 4/27/07 Received medical records from hospital which reveal patient experienced bilious vomiting, lethargy, fever & dehydration x 2 days prior to admit on 3/1/07-3/5/07. Exam revealed tachycardia, decreased bowel sounds & guarding. Rad attempts at reducing IS were unsuccessful & taken to OR for exp lap, reduction of IS & small bowel resection w/primary anastomosis. Developed post op ileus which resolved. Slowed advanced diet & had maroon stools initially. D/c to home. FINAL DX: ileoileal intussusception, surgically reduced & small bowel resection.


Changed on 2/14/2018

VAERS ID: 274937 Before After
VAERS Form:1
Age:0.51
Gender:Female
Location:Unknown
Vaccinated:2007-01-31
Onset:2007-02-27
Submitted:2007-03-26
Entered:2007-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1232F / 3 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Surgery, Enema administration, Intestinal resection

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK LABS: abdominal x-ray revealed SBO. Barium enema revealed IS in mid transverse colon, not completely reduced. US of abdomen + for IS. H/H 10.1/29.0, plts 485, neutros 52.2, lymphs 44.8, monos 2.6. Cl 97, anion gap 19, ca 10.7, creatinine 0.3. Urine sp grav 1.034, ketones 3+
CDC 'Split Type': WAES0703USA04304

Write-up: Information has been received from a physician concerning a 6 month old female who on 31-JAN-2007 was vaccinated with her last dose of Rotateq (lot #654970/0777F) (the dated of the other two doses were not reported). The patient had no medical history or concomitant therapy. On 27-FEB-2007, the patient was examined by the physician and had developed intussusception. The patient''s symptoms at the time of the exam were reported as unknown. On 01-MAR-2007, the patient was hospitalized for intussusception. An enema reduction was attempted unsuccessfully. The patient had bowel resection surgery. On an unspecified date, the patient recovered from intussusception. Her release date from the hospital was not known. The physician considered intussusception to be immediately life-threatening, and disabling, and an other important medical event. There was no product quality complaint involved. Additional information has been requested. 4/13/07 Received medical records & vax records from PCP which reveal child was in good health on day of vax 1/31/07. Growth & development were as expected for age. Lot # for 3rd dose of Rotateq incorrect on VAERS report & corrected in database. 4/27/07 Received medical records from hospital which reveal patient experienced bilious vomiting, lethargy, fever & dehydration x 2 days prior to admit on 3/1/07-3/5/07. Exam revealed tachycardia, decreased bowel sounds & guarding. Rad attempts at reducing IS were unsuccessful & taken to OR for exp lap, reduction of IS & small bowel resection w/primary anastomosis. Developed post op ileus which resolved. Slowed advanced diet & had maroon stools initially. D/c to home. FINAL DX: ileoileal intussusception, surgically reduced & small bowel resection.


Changed on 6/14/2018

VAERS ID: 274937 Before After
VAERS Form:1
Age:0.51
Gender:Female
Location:Unknown
Vaccinated:2007-01-31
Onset:2007-02-27
Submitted:2007-03-26
Entered:2007-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1232F / 3 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Surgery, Enema administration, Intestinal resection

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK LABS: abdominal x-ray revealed SBO. Barium enema revealed IS in mid transverse colon, not completely reduced. US of abdomen + for IS. H/H 10.1/29.0, plts 485, neutros 52.2, lymphs 44.8, monos 2.6. Cl 97, anion gap 19, ca 10.7, creatinine 0.3. Urine sp grav 1.034, ketones 3+
CDC 'Split Type': WAES0703USA04304

Write-up: Information has been received from a physician concerning a 6 month old female who on 31-JAN-2007 was vaccinated with her last dose of Rotateq (lot #654970/0777F) (the dated of the other two doses were not reported). The patient had no medical history or concomitant therapy. On 27-FEB-2007, the patient was examined by the physician and had developed intussusception. The patient''s symptoms at the time of the exam were reported as unknown. On 01-MAR-2007, the patient was hospitalized for intussusception. An enema reduction was attempted unsuccessfully. The patient had bowel resection surgery. On an unspecified date, the patient recovered from intussusception. Her release date from the hospital was not known. The physician considered intussusception to be immediately life-threatening, and disabling, and an other important medical event. There was no product quality complaint involved. Additional information has been requested. 4/13/07 Received medical records & vax records from PCP which reveal child was in good health on day of vax 1/31/07. Growth & development were as expected for age. Lot # for 3rd dose of Rotateq incorrect on VAERS report & corrected in database. 4/27/07 Received medical records from hospital which reveal patient experienced bilious vomiting, lethargy, fever & dehydration x 2 days prior to admit on 3/1/07-3/5/07. Exam revealed tachycardia, decreased bowel sounds & guarding. Rad attempts at reducing IS were unsuccessful & taken to OR for exp lap, reduction of IS & small bowel resection w/primary anastomosis. Developed post op ileus which resolved. Slowed advanced diet & had maroon stools initially. D/c to home. FINAL DX: ileoileal intussusception, surgically reduced & small bowel resection.

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