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This is VAERS ID 278136

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 278136
VAERS Form:
Age:0.2
Gender:Female
Location:New Mexico
Vaccinated:2007-04-18
Onset:2007-04-21
Submitted:2007-05-07
Entered:2007-05-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0026U / - - / PO

Administered by: Other      Purchased by: Unknown
Symptoms: Abdominal distension, Abdominal pain, Abdominal tenderness, Appendicectomy, Abdominal X-ray

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: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None. PMH: none. NKDA.
Allergies:
Diagnostic Lab Data: Unknown. Labs and Diagnostics: Abd X-ray revealed multiple dilated loops of bowel in mid-abdomen. ? Volvulus vs. intussusception. Barium enema (+) for intussusception.
CDC 'Split Type':

Write-up: Information has been received from a registered nurse concerning a 10 week old formula fed female with no medical history or allergies who on 18-APR-2007 was vaccinated with a 2 ml oral dose of Rotateq (lot # 656196/0026U). There was no concomitant medica"tion. On 21-APR-2007 the patient developed vomiting. She was seen in the ER that day. She was admitted to the hospital with intussusception. Barium procedure to open the bowel was unsuccessful. Surgery was required. On 23-APR-2007 the baby was discharged


Changed on 12/8/2009

VAERS ID: 278136 Before After
VAERS Form:
Age:0.2
Gender:Female
Location:New Mexico
Vaccinated:2007-04-18
Onset:2007-04-21
Submitted:2007-05-07
Entered:2007-05-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0026U / - - / PO

Administered by: Other      Purchased by: Unknown Other
Symptoms: Abdominal distension, Abdominal pain, Abdominal tenderness, Appendicectomy, Barium enema, Diarrhoea, Diarrhoea haemorrhagic, Intussusception, Irritability, Small intestinal intussusception reduction, Surgery, Vomiting, Abdominal X-ray

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None. PMH: none. NKDA.
Allergies:
Diagnostic Lab Data: Unknown. Labs and Diagnostics: Abd X-ray revealed multiple dilated loops of bowel in mid-abdomen. ? Volvulus vs. intussusception. Barium enema (+) for intussusception.
CDC 'Split Type': (blank) WAES0704USA05355

Write-up: Information has been received from a registered nurse concerning a 10 week old formula fed female with no medical history or allergies who on 18-APR-2007 was vaccinated with a 2 ml oral dose of Rotateq (lot # 656196/0026U). There was no concomitant medica"tion. medication. On 21-APR-2007 the patient developed vomiting. She was seen in the ER that day. She was admitted to the hospital with intussusception. Barium procedure to open the bowel was unsuccessful. Surgery was required. On 23-APR-2007 the baby was discharged from the hospital. At the time of the report the patient was recovering. There was no product quality complaint involved. The patient''s intussusception was considered to be life threatening and an other important medical event. Additional information has been requested. 05/29/2007 MR received for 2 night ER admit for c/o abdominal pain, vomiting and bloody diarrhea. Hx of diarrhea x 5 days prior to emesis and bloody diarrhea. PE: Irritable infant in moderate distress. Abdomen distended, tender to palpation. Unable to reduce with BE so pt. had surgical reduction of ileocolic intussusception and appendectomy. Final DX: Intussusception.


Changed on 5/13/2013

VAERS ID: 278136 Before After
VAERS Form:
Age:0.2
Gender:Female
Location:New Mexico
Vaccinated:2007-04-18
Onset:2007-04-21
Submitted:2007-05-07
Entered:2007-05-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0026U / - - / PO
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0026U / - - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal distension, Abdominal pain, Abdominal tenderness, Appendicectomy, Barium enema, Diarrhoea, Diarrhoea haemorrhagic, Intussusception, Irritability, Small intestinal intussusception 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None. PMH: none. NKDA.
Allergies:
Diagnostic Lab Data: Unknown. Labs and Diagnostics: Abd X-ray revealed multiple dilated loops of bowel in mid-abdomen. ? Volvulus vs. intussusception. Barium enema (+) for intussusception.
CDC 'Split Type': WAES0704USA05355

Write-up: Information has been received from a registered nurse concerning a 10 week old formula fed female with no medical history or allergies who on 18-APR-2007 was vaccinated with a 2 ml oral dose of Rotateq (lot # 656196/0026U). There was no concomitant medication. On 21-APR-2007 the patient developed vomiting. She was seen in the ER that day. She was admitted to the hospital with intussusception. Barium procedure to open the bowel was unsuccessful. Surgery was required. On 23-APR-2007 the baby was discharged from the hospital. At the time of the report the patient was recovering. There was no product quality complaint involved. The patient''s intussusception was considered to be life threatening and an other important medical event. Additional information has been requested. 05/29/2007 MR received for 2 night ER admit for c/o abdominal pain, vomiting and bloody diarrhea. Hx of diarrhea x 5 days prior to emesis and bloody diarrhea. PE: Irritable infant in moderate distress. Abdomen distended, tender to palpation. Unable to reduce with BE so pt. had surgical reduction of ileocolic intussusception and appendectomy. Final DX: Intussusception.


Changed on 2/14/2017

VAERS ID: 278136 Before After
VAERS Form:
Age:0.2
Gender:Female
Location:New Mexico
Vaccinated:2007-04-18
Onset:2007-04-21
Submitted:2007-05-07
Entered:2007-05-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0026U / - - / PO

Administered by: Other      Purchased by: Other
Symptoms: Abdominal distension, Abdominal pain, Abdominal tenderness, Appendicectomy, Barium enema, Diarrhoea, Diarrhoea haemorrhagic, Intussusception, Irritability, Small intestinal intussusception 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None. PMH: none. NKDA.
Allergies:
Diagnostic Lab Data: Unknown. Labs and Diagnostics: Abd X-ray revealed multiple dilated loops of bowel in mid-abdomen. ? Volvulus vs. intussusception. Barium enema (+) for intussusception.
CDC 'Split Type': WAES0704USA05355

Write-up: Information has been received from a registered nurse concerning a 10 week old formula fed female with no medical history or allergies who on 18-APR-2007 was vaccinated with a 2 ml oral dose of Rotateq (lot # 656196/0026U). There was no concomitant medication. On 21-APR-2007 the patient developed vomiting. She was seen in the ER that day. She was admitted to the hospital with intussusception. Barium procedure to open the bowel was unsuccessful. Surgery was required. On 23-APR-2007 the baby was discharged from the hospital. At the time of the report the patient was recovering. There was no product quality complaint involved. The patient''s intussusception was considered to be life threatening and an other important medical event. Additional information has been requested. 05/29/2007 MR received for 2 night ER admit for c/o abdominal pain, vomiting and bloody diarrhea. Hx of diarrhea x 5 days prior to emesis and bloody diarrhea. PE: Irritable infant in moderate distress. Abdomen distended, tender to palpation. Unable to reduce with BE so pt. had surgical reduction of ileocolic intussusception and appendectomy. Final DX: Intussusception.


Changed on 9/14/2017

VAERS ID: 278136 Before After
VAERS Form:(blank) 1
Age:0.2
Gender:Female
Location:New Mexico
Vaccinated:2007-04-18
Onset:2007-04-21
Submitted:2007-05-07
Entered:2007-05-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0026U / - UNK - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Barium enema, Intussusception, Surgery, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None. PMH: none. NKDA.
Allergies:
Diagnostic Lab Data: Unknown. Labs and Diagnostics: Abd X-ray revealed multiple dilated loops of bowel in mid-abdomen. ? Volvulus vs. intussusception. Barium enema (+) for intussusception.
CDC 'Split Type': WAES0704USA05355

Write-up: Information has been received from a registered nurse concerning a 10 week old formula fed female with no medical history or allergies who on 18-APR-2007 was vaccinated with a 2 ml oral dose of Rotateq (lot # 656196/0026U). There was no concomitant medication. On 21-APR-2007 the patient developed vomiting. She was seen in the ER that day. She was admitted to the hospital with intussusception. Barium procedure to open the bowel was unsuccessful. Surgery was required. On 23-APR-2007 the baby was discharged from the hospital. At the time of the report the patient was recovering. There was no product quality complaint involved. The patient''s intussusception was considered to be life threatening and an other important medical event. Additional information has been requested. 05/29/2007 MR received for 2 night ER admit for c/o abdominal pain, vomiting and bloody diarrhea. Hx of diarrhea x 5 days prior to emesis and bloody diarrhea. PE: Irritable infant in moderate distress. Abdomen distended, tender to palpation. Unable to reduce with BE so pt. had surgical reduction of ileocolic intussusception and appendectomy. Final DX: Intussusception.


Changed on 2/14/2018

VAERS ID: 278136 Before After
VAERS Form:1
Age:0.2
Gender:Female
Location:New Mexico
Vaccinated:2007-04-18
Onset:2007-04-21
Submitted:2007-05-07
Entered:2007-05-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0026U / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Barium enema, Intussusception, Surgery, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None. PMH: none. NKDA.
Allergies:
Diagnostic Lab Data: Unknown. Labs and Diagnostics: Abd X-ray revealed multiple dilated loops of bowel in mid-abdomen. ? Volvulus vs. intussusception. Barium enema (+) for intussusception.
CDC 'Split Type': WAES0704USA05355

Write-up: Information has been received from a registered nurse concerning a 10 week old formula fed female with no medical history or allergies who on 18-APR-2007 was vaccinated with a 2 ml oral dose of Rotateq (lot # 656196/0026U). There was no concomitant medication. On 21-APR-2007 the patient developed vomiting. She was seen in the ER that day. She was admitted to the hospital with intussusception. Barium procedure to open the bowel was unsuccessful. Surgery was required. On 23-APR-2007 the baby was discharged from the hospital. At the time of the report the patient was recovering. There was no product quality complaint involved. The patient''s intussusception was considered to be life threatening and an other important medical event. Additional information has been requested. 05/29/2007 MR received for 2 night ER admit for c/o abdominal pain, vomiting and bloody diarrhea. Hx of diarrhea x 5 days prior to emesis and bloody diarrhea. PE: Irritable infant in moderate distress. Abdomen distended, tender to palpation. Unable to reduce with BE so pt. had surgical reduction of ileocolic intussusception and appendectomy. Final DX: Intussusception.


Changed on 6/14/2018

VAERS ID: 278136 Before After
VAERS Form:1
Age:0.2
Gender:Female
Location:New Mexico
Vaccinated:2007-04-18
Onset:2007-04-21
Submitted:2007-05-07
Entered:2007-05-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0026U / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Barium enema, Intussusception, Surgery, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None. PMH: none. NKDA.
Allergies:
Diagnostic Lab Data: Unknown. Labs and Diagnostics: Abd X-ray revealed multiple dilated loops of bowel in mid-abdomen. ? Volvulus vs. intussusception. Barium enema (+) for intussusception.
CDC 'Split Type': WAES0704USA05355

Write-up: Information has been received from a registered nurse concerning a 10 week old formula fed female with no medical history or allergies who on 18-APR-2007 was vaccinated with a 2 ml oral dose of Rotateq (lot # 656196/0026U). There was no concomitant medication. On 21-APR-2007 the patient developed vomiting. She was seen in the ER that day. She was admitted to the hospital with intussusception. Barium procedure to open the bowel was unsuccessful. Surgery was required. On 23-APR-2007 the baby was discharged from the hospital. At the time of the report the patient was recovering. There was no product quality complaint involved. The patient''s intussusception was considered to be life threatening and an other important medical event. Additional information has been requested. 05/29/2007 MR received for 2 night ER admit for c/o abdominal pain, vomiting and bloody diarrhea. Hx of diarrhea x 5 days prior to emesis and bloody diarrhea. PE: Irritable infant in moderate distress. Abdomen distended, tender to palpation. Unable to reduce with BE so pt. had surgical reduction of ileocolic intussusception and appendectomy. Final DX: Intussusception.


Changed on 8/14/2018

VAERS ID: 278136 Before After
VAERS Form:1
Age:0.2
Gender:Female
Location:New Mexico
Vaccinated:2007-04-18
Onset:2007-04-21
Submitted:2007-05-07
Entered:2007-05-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0026U / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Barium enema, Intussusception, Surgery, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None. PMH: none. NKDA.
Allergies:
Diagnostic Lab Data: Unknown. Labs and Diagnostics: Abd X-ray revealed multiple dilated loops of bowel in mid-abdomen. ? Volvulus vs. intussusception. Barium enema (+) for intussusception.
CDC 'Split Type': WAES0704USA05355

Write-up: Information has been received from a registered nurse concerning a 10 week old formula fed female with no medical history or allergies who on 18-APR-2007 was vaccinated with a 2 ml oral dose of Rotateq (lot # 656196/0026U). There was no concomitant medication. On 21-APR-2007 the patient developed vomiting. She was seen in the ER that day. She was admitted to the hospital with intussusception. Barium procedure to open the bowel was unsuccessful. Surgery was required. On 23-APR-2007 the baby was discharged from the hospital. At the time of the report the patient was recovering. There was no product quality complaint involved. The patient''s intussusception was considered to be life threatening and an other important medical event. Additional information has been requested. 05/29/2007 MR received for 2 night ER admit for c/o abdominal pain, vomiting and bloody diarrhea. Hx of diarrhea x 5 days prior to emesis and bloody diarrhea. PE: Irritable infant in moderate distress. Abdomen distended, tender to palpation. Unable to reduce with BE so pt. had surgical reduction of ileocolic intussusception and appendectomy. Final DX: Intussusception.


Changed on 9/14/2018

VAERS ID: 278136 Before After
VAERS Form:1
Age:0.2
Gender:Female
Location:New Mexico
Vaccinated:2007-04-18
Onset:2007-04-21
Submitted:2007-05-07
Entered:2007-05-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0026U / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Barium enema, Intussusception, Surgery, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None. PMH: none. NKDA.
Allergies:
Diagnostic Lab Data: Unknown. Labs and Diagnostics: Abd X-ray revealed multiple dilated loops of bowel in mid-abdomen. ? Volvulus vs. intussusception. Barium enema (+) for intussusception.
CDC 'Split Type': WAES0704USA05355

Write-up: Information has been received from a registered nurse concerning a 10 week old formula fed female with no medical history or allergies who on 18-APR-2007 was vaccinated with a 2 ml oral dose of Rotateq (lot # 656196/0026U). There was no concomitant medication. On 21-APR-2007 the patient developed vomiting. She was seen in the ER that day. She was admitted to the hospital with intussusception. Barium procedure to open the bowel was unsuccessful. Surgery was required. On 23-APR-2007 the baby was discharged from the hospital. At the time of the report the patient was recovering. There was no product quality complaint involved. The patient''s intussusception was considered to be life threatening and an other important medical event. Additional information has been requested. 05/29/2007 MR received for 2 night ER admit for c/o abdominal pain, vomiting and bloody diarrhea. Hx of diarrhea x 5 days prior to emesis and bloody diarrhea. PE: Irritable infant in moderate distress. Abdomen distended, tender to palpation. Unable to reduce with BE so pt. had surgical reduction of ileocolic intussusception and appendectomy. Final DX: Intussusception.

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