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This is VAERS ID 282368

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 282368
VAERS Form:
Age:0.5
Gender:Male
Location:Unknown
Vaccinated:2007-06-05
Onset:2007-06-05
Submitted:2007-06-19
Entered:2007-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / - UN / UN
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0577F / 2 - / PO

Administered by: Other      Purchased by: Unknown
Symptoms: Anorexia, Barium double contrast, Barium enema, Diarrhoea, Gastrointestinal disorder

Life Threatening? No
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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Barium enema X-ray 06/06/07 - air contrast enema x 2
CDC 'Split Type':

Write-up: Information has been received from a physician concerning a 6 month old male who on approximately 05-JUN-2007 was vaccinated with third dose of Rotateq (LOT# 654248/0577F). Concomitant vaccines included DTaP (also reported as /"Betap/") and poliovirus vac"cine. On 05-JUN-2007, the physician reported that the patient experienced /"fussiness and wasn''''t eating/". The parents took him to the emergency room (ER) and he was released with a diagnoses of /"some gastrointestinal problems/". The patient was also vo


Changed on 12/8/2009

VAERS ID: 282368 Before After
VAERS Form:
Age:0.5
Gender:Male
Location:Unknown
Vaccinated:2007-06-05
Onset:2007-06-05
Submitted:2007-06-19
Entered:2007-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / - UN / UN
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0577F / 2 - / PO

Administered by: Other      Purchased by: Unknown Other
Symptoms: Anorexia, Barium double contrast, Barium enema, Diarrhoea, Gastrointestinal disorder, Intussusception, Irritability, Vomiting, X-ray

Life Threatening? No
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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Barium enema X-ray 06/06/07 - air contrast enema x 2
CDC 'Split Type': (blank) WAES0706USA02578

Write-up: Information has been received from a physician concerning a 6 month old male who on approximately 05-JUN-2007 was vaccinated with third dose of Rotateq (LOT# 654248/0577F). Concomitant vaccines included DTaP (also reported as /"Betap/") "Betap") and poliovirus vac"cine. vaccine. On 05-JUN-2007, the physician reported that the patient experienced /"fussiness "fussiness and wasn''''t eating/". wasn''t eating". The parents took him to the emergency room (ER) and he was released with a diagnoses of /"some "some gastrointestinal problems/". problems". The patient was also vo vomiting and had diarrhea and was taken to the pediactrics'' office the next day and the physician checked him and sent him home. On 06-JUN-2007, the patient was still vomiting and had diarrhea and was again taken to the ER and was admitted with a diagnosis of "intussusception", he had an ''air contrast enema" done twice and "it helped him". The patient was discharged 24 hours later on 07-JUN-2007. The patient''s outcome was reported as recovered. The physician considered intussusception to be an other important medical event. Additional information has been requested.


Changed on 5/13/2013

VAERS ID: 282368 Before After
VAERS Form:
Age:0.5
Gender:Male
Location:Unknown
Vaccinated:2007-06-05
Onset:2007-06-05
Submitted:2007-06-19
Entered:2007-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / - UN / UN
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0577F / 2 - / PO
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0577F / 2 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Anorexia, Barium double contrast, Barium enema, Diarrhoea, Gastrointestinal disorder, Intussusception, Irritability, Vomiting, X-ray

Life Threatening? No
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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Barium enema X-ray 06/06/07 - air contrast enema x 2
CDC 'Split Type': WAES0706USA02578

Write-up: Information has been received from a physician concerning a 6 month old male who on approximately 05-JUN-2007 was vaccinated with third dose of Rotateq (LOT# 654248/0577F). Concomitant vaccines included DTaP (also reported as "Betap") and poliovirus vaccine. On 05-JUN-2007, the physician reported that the patient experienced "fussiness and wasn''t eating". The parents took him to the emergency room (ER) and he was released with a diagnoses of "some gastrointestinal problems". The patient was also vomiting and had diarrhea and was taken to the pediactrics'' office the next day and the physician checked him and sent him home. On 06-JUN-2007, the patient was still vomiting and had diarrhea and was again taken to the ER and was admitted with a diagnosis of "intussusception", he had an ''air contrast enema" done twice and "it helped him". The patient was discharged 24 hours later on 07-JUN-2007. The patient''s outcome was reported as recovered. The physician considered intussusception to be an other important medical event. Additional information has been requested.


Changed on 9/14/2017

VAERS ID: 282368 Before After
VAERS Form:(blank) 1
Age:0.5
Gender:Male
Location:Unknown
Vaccinated:2007-06-05
Onset:2007-06-05
Submitted:2007-06-19
Entered:2007-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK UN / UN
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / - UNK UN / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0577F / 2 3 - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Anorexia, Barium double contrast, Barium enema, Diarrhoea, Gastrointestinal disorder, Intussusception, Irritability, Vomiting, X-ray

Life Threatening? No
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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Barium enema X-ray 06/06/07 - air contrast enema x 2
CDC 'Split Type': WAES0706USA02578

Write-up: Information has been received from a physician concerning a 6 month old male who on approximately 05-JUN-2007 was vaccinated with third dose of Rotateq (LOT# 654248/0577F). Concomitant vaccines included DTaP (also reported as "Betap") and poliovirus vaccine. On 05-JUN-2007, the physician reported that the patient experienced "fussiness and wasn''t eating". The parents took him to the emergency room (ER) and he was released with a diagnoses of "some gastrointestinal problems". The patient was also vomiting and had diarrhea and was taken to the pediactrics'' office the next day and the physician checked him and sent him home. On 06-JUN-2007, the patient was still vomiting and had diarrhea and was again taken to the ER and was admitted with a diagnosis of "intussusception", he had an ''air contrast enema" done twice and "it helped him". The patient was discharged 24 hours later on 07-JUN-2007. The patient''s outcome was reported as recovered. The physician considered intussusception to be an other important medical event. Additional information has been requested.


Changed on 2/14/2018

VAERS ID: 282368 Before After
VAERS Form:1
Age:0.5
Gender:Male
Location:Unknown
Vaccinated:2007-06-05
Onset:2007-06-05
Submitted:2007-06-19
Entered:2007-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / UN
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / UNK UN / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0577F / 3 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Anorexia, Barium double contrast, Barium enema, Diarrhoea, Gastrointestinal disorder, Intussusception, Irritability, Vomiting, X-ray

Life Threatening? No
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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Barium enema X-ray 06/06/07 - air contrast enema x 2
CDC 'Split Type': WAES0706USA02578

Write-up: Information has been received from a physician concerning a 6 month old male who on approximately 05-JUN-2007 was vaccinated with third dose of Rotateq (LOT# 654248/0577F). Concomitant vaccines included DTaP (also reported as "Betap") and poliovirus vaccine. On 05-JUN-2007, the physician reported that the patient experienced "fussiness and wasn''t eating". The parents took him to the emergency room (ER) and he was released with a diagnoses of "some gastrointestinal problems". The patient was also vomiting and had diarrhea and was taken to the pediactrics'' office the next day and the physician checked him and sent him home. On 06-JUN-2007, the patient was still vomiting and had diarrhea and was again taken to the ER and was admitted with a diagnosis of "intussusception", he had an ''air contrast enema" done twice and "it helped him". The patient was discharged 24 hours later on 07-JUN-2007. The patient''s outcome was reported as recovered. The physician considered intussusception to be an other important medical event. Additional information has been requested.


Changed on 6/14/2018

VAERS ID: 282368 Before After
VAERS Form:1
Age:0.5
Gender:Male
Location:Unknown
Vaccinated:2007-06-05
Onset:2007-06-05
Submitted:2007-06-19
Entered:2007-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / UN
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / UNK UN / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0577F / 3 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Anorexia, Barium double contrast, Barium enema, Diarrhoea, Gastrointestinal disorder, Intussusception, Irritability, Vomiting, X-ray

Life Threatening? No
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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Barium enema X-ray 06/06/07 - air contrast enema x 2
CDC 'Split Type': WAES0706USA02578

Write-up: Information has been received from a physician concerning a 6 month old male who on approximately 05-JUN-2007 was vaccinated with third dose of Rotateq (LOT# 654248/0577F). Concomitant vaccines included DTaP (also reported as "Betap") and poliovirus vaccine. On 05-JUN-2007, the physician reported that the patient experienced "fussiness and wasn''t eating". The parents took him to the emergency room (ER) and he was released with a diagnoses of "some gastrointestinal problems". The patient was also vomiting and had diarrhea and was taken to the pediactrics'' office the next day and the physician checked him and sent him home. On 06-JUN-2007, the patient was still vomiting and had diarrhea and was again taken to the ER and was admitted with a diagnosis of "intussusception", he had an ''air contrast enema" done twice and "it helped him". The patient was discharged 24 hours later on 07-JUN-2007. The patient''s outcome was reported as recovered. The physician considered intussusception to be an other important medical event. Additional information has been requested.


Changed on 8/14/2018

VAERS ID: 282368 Before After
VAERS Form:1
Age:0.5
Gender:Male
Location:Unknown
Vaccinated:2007-06-05
Onset:2007-06-05
Submitted:2007-06-19
Entered:2007-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / UN
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / UNK UN / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0577F / 3 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Anorexia, Barium double contrast, Barium enema, Diarrhoea, Gastrointestinal disorder, Intussusception, Irritability, Vomiting, X-ray

Life Threatening? No
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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Barium enema X-ray 06/06/07 - air contrast enema x 2
CDC 'Split Type': WAES0706USA02578

Write-up: Information has been received from a physician concerning a 6 month old male who on approximately 05-JUN-2007 was vaccinated with third dose of Rotateq (LOT# 654248/0577F). Concomitant vaccines included DTaP (also reported as "Betap") and poliovirus vaccine. On 05-JUN-2007, the physician reported that the patient experienced "fussiness and wasn''t eating". The parents took him to the emergency room (ER) and he was released with a diagnoses of "some gastrointestinal problems". The patient was also vomiting and had diarrhea and was taken to the pediactrics'' office the next day and the physician checked him and sent him home. On 06-JUN-2007, the patient was still vomiting and had diarrhea and was again taken to the ER and was admitted with a diagnosis of "intussusception", he had an ''air contrast enema" done twice and "it helped him". The patient was discharged 24 hours later on 07-JUN-2007. The patient''s outcome was reported as recovered. The physician considered intussusception to be an other important medical event. Additional information has been requested.


Changed on 9/14/2018

VAERS ID: 282368 Before After
VAERS Form:1
Age:0.5
Gender:Male
Location:Unknown
Vaccinated:2007-06-05
Onset:2007-06-05
Submitted:2007-06-19
Entered:2007-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / UN
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / UNK UN / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0577F / 3 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Anorexia, Barium double contrast, Barium enema, Diarrhoea, Gastrointestinal disorder, Intussusception, Irritability, Vomiting, X-ray

Life Threatening? No
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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Barium enema X-ray 06/06/07 - air contrast enema x 2
CDC 'Split Type': WAES0706USA02578

Write-up: Information has been received from a physician concerning a 6 month old male who on approximately 05-JUN-2007 was vaccinated with third dose of Rotateq (LOT# 654248/0577F). Concomitant vaccines included DTaP (also reported as "Betap") and poliovirus vaccine. On 05-JUN-2007, the physician reported that the patient experienced "fussiness and wasn''t eating". The parents took him to the emergency room (ER) and he was released with a diagnoses of "some gastrointestinal problems". The patient was also vomiting and had diarrhea and was taken to the pediactrics'' office the next day and the physician checked him and sent him home. On 06-JUN-2007, the patient was still vomiting and had diarrhea and was again taken to the ER and was admitted with a diagnosis of "intussusception", he had an ''air contrast enema" done twice and "it helped him". The patient was discharged 24 hours later on 07-JUN-2007. The patient''s outcome was reported as recovered. The physician considered intussusception to be an other important medical event. Additional information has been requested.

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