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This is VAERS ID 275606

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 275606
VAERS Form:
Age:0.5
Gender:Female
Location:California
Vaccinated:2006-11-14
Onset:2007-03-16
Submitted:2007-04-04
Entered:2007-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / AVENTIS PASTEUR C2489AA / 2 RL / IM
PNC: PNEUMO (PREVNAR) / LEDERLE LABORATORIES BO8658B / 2 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0776F / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Barium double contrast, Diarrhoea, Haematochezia

Life Threatening? No
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     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: no records received 4/24/07- Slight fever, mild congestion, cough and slight drainage from right eye over past 2 days.
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: ultrasound showed intussesception records received 4/24/07-US abdomen:intussusception. Stool WBC and RBC present.
CDC 'Split Type':

Write-up: intusseseption 04/24/07-records received from facility for DOS 03/16-03/17/07-DC DX:Intussusception. Admitted for observation after successful reduction of intussesception by air enema. Presented with abdominal pain, bloody stool. Cramping, colicky interm"ittent. 10 stools in past 24 hours, bloody stools.


Changed on 12/8/2009

VAERS ID: 275606 Before After
VAERS Form:
Age:0.5
Gender:Female
Location:California
Vaccinated:2006-11-14
Onset:2007-03-16
Submitted:2007-04-04
Entered:2007-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / AVENTIS PASTEUR C2489AA / 2 RL / IM
PNC: PNEUMO (PREVNAR) / LEDERLE LABORATORIES BO8658B / 2 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0776F / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Barium double contrast, Diarrhoea, Haematochezia, Intussusception, Pyrexia, Ultrasound scan abnormal

Life Threatening? No
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     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: no records received 4/24/07- Slight fever, mild congestion, cough and slight drainage from right eye over past 2 days.
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: ultrasound showed intussesception records received 4/24/07-US abdomen:intussusception. Stool WBC and RBC present.
CDC 'Split Type':

Write-up: intusseseption 04/24/07-records received from facility for DOS 03/16-03/17/07-DC DX:Intussusception. Admitted for observation after successful reduction of intussesception by air enema. Presented with abdominal pain, bloody stool. Cramping, colicky interm"ittent. intermittent. 10 stools in past 24 hours, bloody stools.


Changed on 3/2/2010

VAERS ID: 275606 Before After
VAERS Form:
Age:0.5
Gender:Female
Location:California
Vaccinated:2006-11-14
Onset:2007-03-16
Submitted:2007-04-04
Entered:2007-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / AVENTIS PASTEUR C2489AA / 2 RL / IM
PNC: PNEUMO (PREVNAR) PNEUMO (PREVNAR7) / LEDERLE LABORATORIES BO8658B / 2 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0776F / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Barium double contrast, Diarrhoea, Haematochezia, Intussusception, Pyrexia, Ultrasound scan abnormal

Life Threatening? No
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     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: no records received 4/24/07- Slight fever, mild congestion, cough and slight drainage from right eye over past 2 days.
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: ultrasound showed intussesception records received 4/24/07-US abdomen:intussusception. Stool WBC and RBC present.
CDC 'Split Type':

Write-up: intusseseption 04/24/07-records received from facility for DOS 03/16-03/17/07-DC DX:Intussusception. Admitted for observation after successful reduction of intussesception by air enema. Presented with abdominal pain, bloody stool. Cramping, colicky intermittent. 10 stools in past 24 hours, bloody stools.


Changed on 4/7/2010

VAERS ID: 275606 Before After
VAERS Form:
Age:0.5
Gender:Female
Location:California
Vaccinated:2006-11-14
Onset:2007-03-16
Submitted:2007-04-04
Entered:2007-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / AVENTIS PASTEUR C2489AA / 2 RL / IM
PNC: PNEUMO (PREVNAR7) PNEUMO (PREVNAR) / LEDERLE LABORATORIES BO8658B / 2 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0776F / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Barium double contrast, Diarrhoea, Haematochezia, Intussusception, Pyrexia, Ultrasound scan abnormal

Life Threatening? No
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     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: no records received 4/24/07- Slight fever, mild congestion, cough and slight drainage from right eye over past 2 days.
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: ultrasound showed intussesception records received 4/24/07-US abdomen:intussusception. Stool WBC and RBC present.
CDC 'Split Type':

Write-up: intusseseption 04/24/07-records received from facility for DOS 03/16-03/17/07-DC DX:Intussusception. Admitted for observation after successful reduction of intussesception by air enema. Presented with abdominal pain, bloody stool. Cramping, colicky intermittent. 10 stools in past 24 hours, bloody stools.


Changed on 5/13/2013

VAERS ID: 275606 Before After
VAERS Form:
Age:0.5
Gender:Female
Location:California
Vaccinated:2006-11-14
Onset:2007-03-16
Submitted:2007-04-04
Entered:2007-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / AVENTIS PASTEUR C2489AA / 2 RL / IM
PNC: PNEUMO (PREVNAR) / LEDERLE LABORATORIES BO8658B / 2 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0776F / 0 - / PO
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0776F / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Barium double contrast, Diarrhoea, Haematochezia, Intussusception, Pyrexia, Ultrasound scan abnormal

Life Threatening? No
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     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: no records received 4/24/07- Slight fever, mild congestion, cough and slight drainage from right eye over past 2 days.
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: ultrasound showed intussesception records received 4/24/07-US abdomen:intussusception. Stool WBC and RBC present.
CDC 'Split Type':

Write-up: intusseseption 04/24/07-records received from facility for DOS 03/16-03/17/07-DC DX:Intussusception. Admitted for observation after successful reduction of intussesception by air enema. Presented with abdominal pain, bloody stool. Cramping, colicky intermittent. 10 stools in past 24 hours, bloody stools.


Changed on 2/14/2017

VAERS ID: 275606 Before After
VAERS Form:
Age:0.5 0.51
Gender:Female
Location:California
Vaccinated:2006-11-14
Onset:2007-03-16
Submitted:2007-04-04
Entered:2007-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / AVENTIS PASTEUR SANOFI PASTEUR C2489AA / 2 RL / IM
PNC: PNEUMO (PREVNAR) / LEDERLE LABORATORIES PFIZER/WYETH BO8658B / 2 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0776F / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Barium double contrast, Diarrhoea, Haematochezia, Intussusception, Pyrexia, Ultrasound scan abnormal

Life Threatening? No
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     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: no records received 4/24/07- Slight fever, mild congestion, cough and slight drainage from right eye over past 2 days.
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: ultrasound showed intussesception records received 4/24/07-US abdomen:intussusception. Stool WBC and RBC present.
CDC 'Split Type':

Write-up: intusseseption 04/24/07-records received from facility for DOS 03/16-03/17/07-DC DX:Intussusception. Admitted for observation after successful reduction of intussesception by air enema. Presented with abdominal pain, bloody stool. Cramping, colicky intermittent. 10 stools in past 24 hours, bloody stools.


Changed on 9/14/2017

VAERS ID: 275606 Before After
VAERS Form:(blank) 1
Age:0.51
Gender:Female
Location:California
Vaccinated:2006-11-14
Onset:2007-03-16
Submitted:2007-04-04
Entered:2007-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2489AA / 2 3 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH BO8658B / 2 3 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0776F / 0 1 - MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intussusception, Ultrasound scan abnormal

Life Threatening? No
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     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: no records received 4/24/07- Slight fever, mild congestion, cough and slight drainage from right eye over past 2 days.
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: ultrasound showed intussesception records received 4/24/07-US abdomen:intussusception. Stool WBC and RBC present.
CDC 'Split Type':

Write-up: intusseseption 04/24/07-records received from facility for DOS 03/16-03/17/07-DC DX:Intussusception. Admitted for observation after successful reduction of intussesception by air enema. Presented with abdominal pain, bloody stool. Cramping, colicky intermittent. 10 stools in past 24 hours, bloody stools.


Changed on 2/14/2018

VAERS ID: 275606 Before After
VAERS Form:1
Age:0.51
Gender:Female
Location:California
Vaccinated:2006-11-14
Onset:2007-03-16
Submitted:2007-04-04
Entered:2007-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2489AA / 3 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH BO8658B / 3 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0776F / 1 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intussusception, Ultrasound scan abnormal

Life Threatening? No
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     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: no records received 4/24/07- Slight fever, mild congestion, cough and slight drainage from right eye over past 2 days.
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: ultrasound showed intussesception records received 4/24/07-US abdomen:intussusception. Stool WBC and RBC present.
CDC 'Split Type':

Write-up: intusseseption 04/24/07-records received from facility for DOS 03/16-03/17/07-DC DX:Intussusception. Admitted for observation after successful reduction of intussesception by air enema. Presented with abdominal pain, bloody stool. Cramping, colicky intermittent. 10 stools in past 24 hours, bloody stools.


Changed on 6/14/2018

VAERS ID: 275606 Before After
VAERS Form:1
Age:0.51
Gender:Female
Location:California
Vaccinated:2006-11-14
Onset:2007-03-16
Submitted:2007-04-04
Entered:2007-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2489AA / 3 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH BO8658B / 3 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0776F / 1 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intussusception, Ultrasound scan abnormal

Life Threatening? No
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     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: no records received 4/24/07- Slight fever, mild congestion, cough and slight drainage from right eye over past 2 days.
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: ultrasound showed intussesception records received 4/24/07-US abdomen:intussusception. Stool WBC and RBC present.
CDC 'Split Type':

Write-up: intusseseption 04/24/07-records received from facility for DOS 03/16-03/17/07-DC DX:Intussusception. Admitted for observation after successful reduction of intussesception by air enema. Presented with abdominal pain, bloody stool. Cramping, colicky intermittent. 10 stools in past 24 hours, bloody stools.

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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=275606&WAYBACKHISTORY=ON


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