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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 284183 |
VAERS Form: | |
Age: | 0.2 |
Sex: | Female |
Location: | Unknown |
Vaccinated: | 2007-05-15 |
Onset: | 2007-05-22 |
Submitted: | 2007-07-09 |
Entered: | 2007-07-10 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR | C2628M / 0 | LL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1416F / 0 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | Z0922 / 0 | LL / IM |
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC | B0876920 / 0 | RL / IM |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0235N / 0 | - / PO |
Administered by: Unknown Purchased by: Unknown
Symptoms: Abdominal mass, Abnormal faeces, Barium enema, Blood culture negative, Culture stool negative
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: 2
Write-up: Information has been received from a physician concerning a female who was vaccinated with Rotateq PO 2nd dose. Concomitant therapy included /"other vaccines at the same time./" Subsequently the patient developed an intussusception and was hospitalized. T"he physician reported that the intussusception was reduced with a barium enema and no surgery was needed. The physician reported that the patient recovered on an unspecified date. The physician reported that intussusception required intervention to preven
Vaccinated: | 2007-05-15 |
Onset: | 2007-05-22 |
Submitted: | 2007-07-09 |
Entered: | 2007-07-10 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR | C2628M / 0 | LL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1416F / 0 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | Z0922 / 0 | LL / IM |
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC | B0876920 / 0 | RL / IM |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0235N / 0 | - / PO |
Administered by: Unknown Purchased by: Unknown
Symptoms: Abdominal mass, Abnormal faeces, Barium enema, Blood culture negative, Culture stool negative, Culture urine negative, Faeces discoloured, Intussusception, Lethargy, Mucosal dryness, Urinary system X-ray, Vomiting, Ultrasound abdomen, Fluid intake reduced, Occult blood positive
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: 2
Write-up: Information has been received from a physician concerning a female who was vaccinated with Rotateq PO 2nd dose. Concomitant therapy included /"other "other vaccines at the same time./" time." Subsequently the patient developed an intussusception and was hospitalized. T"he The physician reported that the intussusception was reduced with a barium enema and no surgery was needed. The physician reported that the patient recovered on an unspecified date. The physician reported that intussusception required intervention to preven prevent serious criteria and caused or prolonged hospitalization. Additional information has been requested. 07/18/2007 Vax record and Diagnostic studies from hospital stay received from PCP. Vax info updated in VAERS database. 07/30/2007 MR received for hospital DOS 5/22-24/2007. Infant presented to ER with 3 day hx of emesis, dark, foul smelling stools, decreased intake and lethargy. PE reveals lethargy, dry mucus membranes, a palpable mass in the RUQ, and guiac (+) stool. Final DX: Intussusception.
Vaccinated: | 2007-05-15 |
Onset: | 2007-05-22 |
Submitted: | 2007-07-09 |
Entered: | 2007-07-10 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR | C2628M / 0 | LL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1416F / 0 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | Z0922 / 0 | LL / IM |
PNC: PNEUMO (PREVNAR) PNEUMO (PREVNAR7) / WYETH PHARMACEUTICALS, INC | B0876920 / 0 | RL / IM |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0235N / 0 | - / PO |
Administered by: Unknown Purchased by: Unknown
Symptoms: Abdominal mass, Abnormal faeces, Barium enema, Blood culture negative, Culture stool negative, Culture urine negative, Faeces discoloured, Intussusception, Lethargy, Mucosal dryness, Urinary system X-ray, Vomiting, Ultrasound abdomen, Fluid intake reduced, Occult blood positive
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: 2
Write-up: Information has been received from a physician concerning a female who was vaccinated with Rotateq PO 2nd dose. Concomitant therapy included "other vaccines at the same time." Subsequently the patient developed an intussusception and was hospitalized. The physician reported that the intussusception was reduced with a barium enema and no surgery was needed. The physician reported that the patient recovered on an unspecified date. The physician reported that intussusception required intervention to prevent serious criteria and caused or prolonged hospitalization. Additional information has been requested. 07/18/2007 Vax record and Diagnostic studies from hospital stay received from PCP. Vax info updated in VAERS database. 07/30/2007 MR received for hospital DOS 5/22-24/2007. Infant presented to ER with 3 day hx of emesis, dark, foul smelling stools, decreased intake and lethargy. PE reveals lethargy, dry mucus membranes, a palpable mass in the RUQ, and guiac (+) stool. Final DX: Intussusception.
Vaccinated: | 2007-05-15 |
Onset: | 2007-05-22 |
Submitted: | 2007-07-09 |
Entered: | 2007-07-10 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR | C2628M / 0 | LL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1416F / 0 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | Z0922 / 0 | LL / IM |
PNC: PNEUMO (PREVNAR7) PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC | B0876920 / 0 | RL / IM |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0235N / 0 | - / PO |
Administered by: Unknown Purchased by: Unknown
Symptoms: Abdominal mass, Abnormal faeces, Barium enema, Blood culture negative, Culture stool negative, Culture urine negative, Faeces discoloured, Intussusception, Lethargy, Mucosal dryness, Urinary system X-ray, Vomiting, Ultrasound abdomen, Fluid intake reduced, Occult blood positive
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: 2
Write-up: Information has been received from a physician concerning a female who was vaccinated with Rotateq PO 2nd dose. Concomitant therapy included "other vaccines at the same time." Subsequently the patient developed an intussusception and was hospitalized. The physician reported that the intussusception was reduced with a barium enema and no surgery was needed. The physician reported that the patient recovered on an unspecified date. The physician reported that intussusception required intervention to prevent serious criteria and caused or prolonged hospitalization. Additional information has been requested. 07/18/2007 Vax record and Diagnostic studies from hospital stay received from PCP. Vax info updated in VAERS database. 07/30/2007 MR received for hospital DOS 5/22-24/2007. Infant presented to ER with 3 day hx of emesis, dark, foul smelling stools, decreased intake and lethargy. PE reveals lethargy, dry mucus membranes, a palpable mass in the RUQ, and guiac (+) stool. Final DX: Intussusception.
Vaccinated: | 2007-05-15 |
Onset: | 2007-05-22 |
Submitted: | 2007-07-09 |
Entered: | 2007-07-10 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR | C2628M / 0 | LL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1416F / 0 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | Z0922 / 0 | LL / IM |
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH | B0876920 / 0 | RL / IM |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0235N / 0 | - / PO |
Administered by: Unknown Purchased by: Unknown
Symptoms: Abdominal mass, Abnormal faeces, Barium enema, Blood culture negative, Culture stool negative, Culture urine negative, Faeces discoloured, Intussusception, Lethargy, Mucosal dryness, Urinary system X-ray, Vomiting, Ultrasound abdomen, Fluid intake reduced, Occult blood positive
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: 2
Write-up: Information has been received from a physician concerning a female who was vaccinated with Rotateq PO 2nd dose. Concomitant therapy included "other vaccines at the same time." Subsequently the patient developed an intussusception and was hospitalized. The physician reported that the intussusception was reduced with a barium enema and no surgery was needed. The physician reported that the patient recovered on an unspecified date. The physician reported that intussusception required intervention to prevent serious criteria and caused or prolonged hospitalization. Additional information has been requested. 07/18/2007 Vax record and Diagnostic studies from hospital stay received from PCP. Vax info updated in VAERS database. 07/30/2007 MR received for hospital DOS 5/22-24/2007. Infant presented to ER with 3 day hx of emesis, dark, foul smelling stools, decreased intake and lethargy. PE reveals lethargy, dry mucus membranes, a palpable mass in the RUQ, and guiac (+) stool. Final DX: Intussusception.
Vaccinated: | 2007-05-15 |
Onset: | 2007-05-22 |
Submitted: | 2007-07-09 |
Entered: | 2007-07-10 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR | C2628M / 0 | LL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1416F / 0 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | Z0922 / 0 | LL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B0876920 / 0 | RL / IM |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0235N / 0 | - / PO |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0235N / 0 | - / PO |
Administered by: Unknown Purchased by: Unknown
Symptoms: Abdominal mass, Abnormal faeces, Barium enema, Blood culture negative, Culture stool negative, Culture urine negative, Faeces discoloured, Intussusception, Lethargy, Mucosal dryness, Urinary system X-ray, Vomiting, Ultrasound abdomen, Fluid intake reduced, Occult blood positive
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: 2
Write-up: Information has been received from a physician concerning a female who was vaccinated with Rotateq PO 2nd dose. Concomitant therapy included "other vaccines at the same time." Subsequently the patient developed an intussusception and was hospitalized. The physician reported that the intussusception was reduced with a barium enema and no surgery was needed. The physician reported that the patient recovered on an unspecified date. The physician reported that intussusception required intervention to prevent serious criteria and caused or prolonged hospitalization. Additional information has been requested. 07/18/2007 Vax record and Diagnostic studies from hospital stay received from PCP. Vax info updated in VAERS database. 07/30/2007 MR received for hospital DOS 5/22-24/2007. Infant presented to ER with 3 day hx of emesis, dark, foul smelling stools, decreased intake and lethargy. PE reveals lethargy, dry mucus membranes, a palpable mass in the RUQ, and guiac (+) stool. Final DX: Intussusception.
Vaccinated: | 2007-05-15 |
Onset: | 2007-05-22 |
Submitted: | 2007-07-09 |
Entered: | 2007-07-10 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR | C2628M / 0 | LL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1416F / 0 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | Z0922 / 0 | LL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B0876920 / 0 | RL / IM |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0235N / 0 | - / PO |
Administered by: Unknown Purchased by: Unknown
Symptoms: Abdominal mass, Abnormal faeces, Barium enema, Blood culture negative, Culture stool negative, Culture urine negative, Faeces discoloured, Intussusception, Lethargy, Mucosal dryness, Urinary system X-ray, Vomiting, Ultrasound abdomen, Fluid intake reduced, Occult blood positive
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: 2
Write-up: Information has been received from a physician concerning a female who was vaccinated with Rotateq PO 2nd dose. Concomitant therapy included "other vaccines at the same time." Subsequently the patient developed an intussusception and was hospitalized. The physician reported that the intussusception was reduced with a barium enema and no surgery was needed. The physician reported that the patient recovered on an unspecified date. The physician reported that intussusception required intervention to prevent serious criteria and caused or prolonged hospitalization. Additional information has been requested. 07/18/2007 Vax record and Diagnostic studies from hospital stay received from PCP. Vax info updated in VAERS database. 07/30/2007 MR received for hospital DOS 5/22-24/2007. Infant presented to ER with 3 day hx of emesis, dark, foul smelling stools, decreased intake and lethargy. PE reveals lethargy, dry mucus membranes, a palpable mass in the RUQ, and guiac (+) stool. Final DX: Intussusception.
Vaccinated: | 2007-05-15 |
Onset: | 2007-05-22 |
Submitted: | 2007-07-09 |
Entered: | 2007-07-10 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR | C2628M / 0 1 | LL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1416F / 0 1 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | Z0922 / 0 1 | LL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B0876920 / 0 1 | RL / IM |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0235N / 0 1 | - MO / PO |
Administered by: Unknown Purchased by: Unknown
Symptoms: Barium enema, Intussusception
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: 2
Write-up: Information has been received from a physician concerning a female who was vaccinated with Rotateq PO 2nd dose. Concomitant therapy included "other vaccines at the same time." Subsequently the patient developed an intussusception and was hospitalized. The physician reported that the intussusception was reduced with a barium enema and no surgery was needed. The physician reported that the patient recovered on an unspecified date. The physician reported that intussusception required intervention to prevent serious criteria and caused or prolonged hospitalization. Additional information has been requested. 07/18/2007 Vax record and Diagnostic studies from hospital stay received from PCP. Vax info updated in VAERS database. 07/30/2007 MR received for hospital DOS 5/22-24/2007. Infant presented to ER with 3 day hx of emesis, dark, foul smelling stools, decreased intake and lethargy. PE reveals lethargy, dry mucus membranes, a palpable mass in the RUQ, and guiac (+) stool. Final DX: Intussusception.
Vaccinated: | 2007-05-15 |
Onset: | 2007-05-22 |
Submitted: | 2007-07-09 |
Entered: | 2007-07-10 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR | C2628M / 1 | LL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1416F / 1 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | Z0922 / 1 | LL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B0876920 / 1 | RL / IM |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0235N / 1 | MO / PO |
Administered by: Unknown Purchased by: Unknown
Symptoms: Barium enema, Intussusception
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: 2
Write-up: Information has been received from a physician concerning a female who was vaccinated with Rotateq PO 2nd dose. Concomitant therapy included "other vaccines at the same time." Subsequently the patient developed an intussusception and was hospitalized. The physician reported that the intussusception was reduced with a barium enema and no surgery was needed. The physician reported that the patient recovered on an unspecified date. The physician reported that intussusception required intervention to prevent serious criteria and caused or prolonged hospitalization. Additional information has been requested. 07/18/2007 Vax record and Diagnostic studies from hospital stay received from PCP. Vax info updated in VAERS database. 07/30/2007 MR received for hospital DOS 5/22-24/2007. Infant presented to ER with 3 day hx of emesis, dark, foul smelling stools, decreased intake and lethargy. PE reveals lethargy, dry mucus membranes, a palpable mass in the RUQ, and guiac (+) stool. Final DX: Intussusception.
Vaccinated: | 2007-05-15 |
Onset: | 2007-05-22 |
Submitted: | 2007-07-09 |
Entered: | 2007-07-10 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR | C2628M / 1 | LL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1416F / 1 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | Z0922 / 1 | LL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B0876920 / 1 | RL / IM |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0235N / 1 | MO / PO |
Administered by: Unknown Purchased by: Unknown
Symptoms: Barium enema, Intussusception
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: 2
Write-up: Information has been received from a physician concerning a female who was vaccinated with Rotateq PO 2nd dose. Concomitant therapy included "other vaccines at the same time." Subsequently the patient developed an intussusception and was hospitalized. The physician reported that the intussusception was reduced with a barium enema and no surgery was needed. The physician reported that the patient recovered on an unspecified date. The physician reported that intussusception required intervention to prevent serious criteria and caused or prolonged hospitalization. Additional information has been requested. 07/18/2007 Vax record and Diagnostic studies from hospital stay received from PCP. Vax info updated in VAERS database. 07/30/2007 MR received for hospital DOS 5/22-24/2007. Infant presented to ER with 3 day hx of emesis, dark, foul smelling stools, decreased intake and lethargy. PE reveals lethargy, dry mucus membranes, a palpable mass in the RUQ, and guiac (+) stool. Final DX: Intussusception.
Vaccinated: | 2007-05-15 |
Onset: | 2007-05-22 |
Submitted: | 2007-07-09 |
Entered: | 2007-07-10 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR | C2628M / 1 | LL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1416F / 1 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | Z0922 / 1 | LL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B0876920 / 1 | RL / IM |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0235N / 1 | MO / PO |
Administered by: Unknown Purchased by: Unknown
Symptoms: Barium enema, Intussusception
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: 2
Write-up: Information has been received from a physician concerning a female who was vaccinated with Rotateq PO 2nd dose. Concomitant therapy included "other vaccines at the same time." Subsequently the patient developed an intussusception and was hospitalized. The physician reported that the intussusception was reduced with a barium enema and no surgery was needed. The physician reported that the patient recovered on an unspecified date. The physician reported that intussusception required intervention to prevent serious criteria and caused or prolonged hospitalization. Additional information has been requested. 07/18/2007 Vax record and Diagnostic studies from hospital stay received from PCP. Vax info updated in VAERS database. 07/30/2007 MR received for hospital DOS 5/22-24/2007. Infant presented to ER with 3 day hx of emesis, dark, foul smelling stools, decreased intake and lethargy. PE reveals lethargy, dry mucus membranes, a palpable mass in the RUQ, and guiac (+) stool. Final DX: Intussusception.
Vaccinated: | 2007-05-15 |
Onset: | 2007-05-22 |
Submitted: | 2007-07-09 |
Entered: | 2007-07-10 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR | C2628M / 1 | LL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1416F / 1 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | Z0922 / 1 | LL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B0876920 / 1 | RL / IM |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0235N / 1 | MO / PO |
Administered by: Unknown Purchased by: Unknown
Symptoms: Barium enema, Intussusception
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: 2
Write-up: Information has been received from a physician concerning a female who was vaccinated with Rotateq PO 2nd dose. Concomitant therapy included "other vaccines at the same time." Subsequently the patient developed an intussusception and was hospitalized. The physician reported that the intussusception was reduced with a barium enema and no surgery was needed. The physician reported that the patient recovered on an unspecified date. The physician reported that intussusception required intervention to prevent serious criteria and caused or prolonged hospitalization. Additional information has been requested. 07/18/2007 Vax record and Diagnostic studies from hospital stay received from PCP. Vax info updated in VAERS database. 07/30/2007 MR received for hospital DOS 5/22-24/2007. Infant presented to ER with 3 day hx of emesis, dark, foul smelling stools, decreased intake and lethargy. PE reveals lethargy, dry mucus membranes, a palpable mass in the RUQ, and guiac (+) stool. Final DX: Intussusception.
Vaccinated: | 2007-05-15 |
Onset: | 2007-05-22 |
Submitted: | 2007-07-09 |
Entered: | 2007-07-10 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR | C2628M / 1 | LL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1416F / 1 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | Z0922 / 1 | LL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B0876920 / 1 | RL / IM |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0235N / 1 | MO / PO |
Administered by: Unknown Purchased by: Unknown
Symptoms: Barium enema, Intussusception
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: 2
Write-up: Information has been received from a physician concerning a female who was vaccinated with Rotateq PO 2nd dose. Concomitant therapy included "other vaccines at the same time." Subsequently the patient developed an intussusception and was hospitalized. The physician reported that the intussusception was reduced with a barium enema and no surgery was needed. The physician reported that the patient recovered on an unspecified date. The physician reported that intussusception required intervention to prevent serious criteria and caused or prolonged hospitalization. Additional information has been requested. 07/18/2007 Vax record and Diagnostic studies from hospital stay received from PCP. Vax info updated in VAERS database. 07/30/2007 MR received for hospital DOS 5/22-24/2007. Infant presented to ER with 3 day hx of emesis, dark, foul smelling stools, decreased intake and lethargy. PE reveals lethargy, dry mucus membranes, a palpable mass in the RUQ, and guiac (+) stool. Final DX: Intussusception.
Vaccinated: | 2007-05-15 |
Onset: | 2007-05-22 |
Submitted: | 2007-07-09 |
Entered: | 2007-07-10 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR | C2628M / 1 | LL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1416F / 1 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | Z0922 / 1 | LL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B0876920 / 1 | RL / IM |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0235N / 1 | MO / PO |
Administered by: Unknown Purchased by: Unknown
Symptoms: Barium enema, Intussusception
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: 2
Write-up: Information has been received from a physician concerning a female who was vaccinated with Rotateq PO 2nd dose. Concomitant therapy included "other vaccines at the same time." Subsequently the patient developed an intussusception and was hospitalized. The physician reported that the intussusception was reduced with a barium enema and no surgery was needed. The physician reported that the patient recovered on an unspecified date. The physician reported that intussusception required intervention to prevent serious criteria and caused or prolonged hospitalization. Additional information has been requested. 07/18/2007 Vax record and Diagnostic studies from hospital stay received from PCP. Vax info updated in VAERS database. 07/30/2007 MR received for hospital DOS 5/22-24/2007. Infant presented to ER with 3 day hx of emesis, dark, foul smelling stools, decreased intake and lethargy. PE reveals lethargy, dry mucus membranes, a palpable mass in the RUQ, and guiac (+) stool. Final DX: Intussusception.
Vaccinated: | 2007-05-15 |
Onset: | 2007-05-22 |
Submitted: | 2007-07-09 |
Entered: | 2007-07-10 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR | C2628M / 1 | LL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1416F / 1 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | Z0922 / 1 | LL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B0876920 / 1 | RL / IM |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0235N / 1 | MO / PO |
Administered by: Unknown Purchased by: Unknown
Symptoms: Barium enema, Intussusception
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: 2
Write-up: Information has been received from a physician concerning a female who was vaccinated with Rotateq PO 2nd dose. Concomitant therapy included "other vaccines at the same time." Subsequently the patient developed an intussusception and was hospitalized. The physician reported that the intussusception was reduced with a barium enema and no surgery was needed. The physician reported that the patient recovered on an unspecified date. The physician reported that intussusception required intervention to prevent serious criteria and caused or prolonged hospitalization. Additional information has been requested. 07/18/2007 Vax record and Diagnostic studies from hospital stay received from PCP. Vax info updated in VAERS database. 07/30/2007 MR received for hospital DOS 5/22-24/2007. Infant presented to ER with 3 day hx of emesis, dark, foul smelling stools, decreased intake and lethargy. PE reveals lethargy, dry mucus membranes, a palpable mass in the RUQ, and guiac (+) stool. Final DX: Intussusception.
Link To This Search Result:
https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=284183&WAYBACKHISTORY=ON
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