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This is VAERS ID 283501

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 283501
VAERS Form:
Age:0.3
Gender:Female
Location:Foreign
Vaccinated:2006-11-03
Onset:2006-11-27
Submitted:2007-06-29
Entered:2007-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / - - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Crying, Death, Haematochezia, Intussusception, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2006-11-27
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Diarrhoea; Malnutrition
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0706CRI00010

Write-up: Information has been received from a health professional concerning a 4 month old female with a history of diarrhoea and malnutrition who on 03-NOV-2006 was vaccinated with Rotateq. There was no concomitant medication. On approximately 27-NOV-2006 the patient experienced intussusception, crying, hematochezia and vomiting and was hospitalized. The reporter felt that intussusception, crying, hematochezia and vomiting were not related to therapy with Rotateq. Patient died on 27-NOV-06. Additional information is not expected.


Changed on 5/13/2013

VAERS ID: 283501 Before After
VAERS Form:
Age:0.3
Gender:Female
Location:Foreign
Vaccinated:2006-11-03
Onset:2006-11-27
Submitted:2007-06-29
Entered:2007-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / - - / PO
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / - - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Crying, Death, Haematochezia, Intussusception, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2006-11-27
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Diarrhoea; Malnutrition
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0706CRI00010

Write-up: Information has been received from a health professional concerning a 4 month old female with a history of diarrhoea and malnutrition who on 03-NOV-2006 was vaccinated with Rotateq. There was no concomitant medication. On approximately 27-NOV-2006 the patient experienced intussusception, crying, hematochezia and vomiting and was hospitalized. The reporter felt that intussusception, crying, hematochezia and vomiting were not related to therapy with Rotateq. Patient died on 27-NOV-06. Additional information is not expected.


Changed on 2/14/2017

VAERS ID: 283501 Before After
VAERS Form:
Age:0.3 0.33
Gender:Female
Location:Foreign
Vaccinated:2006-11-03
Onset:2006-11-27
Submitted:2007-06-29
Entered:2007-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / - - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Crying, Death, Haematochezia, Intussusception, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2006-11-27
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Diarrhoea; Malnutrition
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0706CRI00010

Write-up: Information has been received from a health professional concerning a 4 month old female with a history of diarrhoea and malnutrition who on 03-NOV-2006 was vaccinated with Rotateq. There was no concomitant medication. On approximately 27-NOV-2006 the patient experienced intussusception, crying, hematochezia and vomiting and was hospitalized. The reporter felt that intussusception, crying, hematochezia and vomiting were not related to therapy with Rotateq. Patient died on 27-NOV-06. Additional information is not expected.


Changed on 9/14/2017

VAERS ID: 283501 Before After
VAERS Form:(blank) 1
Age:0.33
Gender:Female
Location:Foreign
Vaccinated:2006-11-03
Onset:2006-11-27
Submitted:2007-06-29
Entered:2007-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / - UNK - MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Crying, Death, Haematochezia, Intussusception, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2006-11-27
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Diarrhoea; Malnutrition
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0706CRI00010

Write-up: Information has been received from a health professional concerning a 4 month old female with a history of diarrhoea and malnutrition who on 03-NOV-2006 was vaccinated with Rotateq. There was no concomitant medication. On approximately 27-NOV-2006 the patient experienced intussusception, crying, hematochezia and vomiting and was hospitalized. The reporter felt that intussusception, crying, hematochezia and vomiting were not related to therapy with Rotateq. Patient died on 27-NOV-06. Additional information is not expected.


Changed on 2/14/2018

VAERS ID: 283501 Before After
VAERS Form:1
Age:0.33
Gender:Female
Location:Foreign
Vaccinated:2006-11-03
Onset:2006-11-27
Submitted:2007-06-29
Entered:2007-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / UNK MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Crying, Death, Haematochezia, Intussusception, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2006-11-27
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Diarrhoea; Malnutrition
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0706CRI00010

Write-up: Information has been received from a health professional concerning a 4 month old female with a history of diarrhoea and malnutrition who on 03-NOV-2006 was vaccinated with Rotateq. There was no concomitant medication. On approximately 27-NOV-2006 the patient experienced intussusception, crying, hematochezia and vomiting and was hospitalized. The reporter felt that intussusception, crying, hematochezia and vomiting were not related to therapy with Rotateq. Patient died on 27-NOV-06. Additional information is not expected.


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