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This is VAERS ID 286188

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 286188
VAERS Form:
Age:0.5
Gender:Male
Location:New Jersey
Vaccinated:2007-03-24
Onset:2007-07-22
Submitted:2007-07-27
Entered:2007-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1239F / 2 UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Abdominal pain, Crying, Intussusception, Enema administration, Poor quality sleep

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: barium enema X-ray - IT corrected
CDC 'Split Type':

Write-up: Information has been received from a registered nurse concerning a 10-month-old male who on 13-NOV-2006, 12-JAN-2007, and 24-MAR-2007 was vaccinated with the first, second, and third doses of Rotateq. On 22-JUL-2007 the patient experienced intussusception"and was hospitalized. The intussusception was corrected with a barium enema and the child was released from the hospital. The patient recovered. No other information was available. Intussusception was considered to be immediately life-threatening and an o


Changed on 12/8/2009

VAERS ID: 286188 Before After
VAERS Form:
Age:0.5
Gender:Male
Location:New Jersey
Vaccinated:2007-03-24
Onset:2007-07-22
Submitted:2007-07-27
Entered:2007-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1239F / 2 UN / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Abdominal pain, Crying, Intussusception, Urinary system X-ray, Enema administration, Ultrasound abdomen abnormal, Poor quality sleep

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: barium enema X-ray - IT corrected 8/27/07-records received-Xray KUB: stool filled colon. US abdomen: RUQ intussusception. Fluoroscopically guided air enema reduced intussusception. PMH: pylonmyotomy at 5 weeks for pyloric stenosis. Labs: n
CDC 'Split Type': (blank) WAES0707USA04056

Write-up: Information has been received from a registered nurse concerning a 10-month-old male who on 13-NOV-2006, 12-JAN-2007, and 24-MAR-2007 was vaccinated with the first, second, and third doses of Rotateq. On 22-JUL-2007 the patient experienced intussusception"and intussusception and was hospitalized. The intussusception was corrected with a barium enema and the child was released from the hospital. The patient recovered. No other information was available. Intussusception was considered to be immediately life-threatening and an o other important medical event by the reporter. Additional information has been requested. 8/27/07-records received for DOS-7/22/07-DX: Intussusception. Reduced with Barium enema. C/O abdominal pain since toady 7/22/07-Cranky, crying, waking up. No fever. No vomiting. No diarrhea. No rash.


Changed on 5/13/2013

VAERS ID: 286188 Before After
VAERS Form:
Age:0.5
Gender:Male
Location:New Jersey
Vaccinated:2007-03-24
Onset:2007-07-22
Submitted:2007-07-27
Entered:2007-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1239F / 2 UN / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1239F / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Crying, Intussusception, Urinary system X-ray, Enema administration, Ultrasound abdomen abnormal, Poor quality sleep

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: barium enema X-ray - IT corrected 8/27/07-records received-Xray KUB: stool filled colon. US abdomen: RUQ intussusception. Fluoroscopically guided air enema reduced intussusception. PMH: pylonmyotomy at 5 weeks for pyloric stenosis. Labs: n
CDC 'Split Type': WAES0707USA04056

Write-up: Information has been received from a registered nurse concerning a 10-month-old male who on 13-NOV-2006, 12-JAN-2007, and 24-MAR-2007 was vaccinated with the first, second, and third doses of Rotateq. On 22-JUL-2007 the patient experienced intussusception and was hospitalized. The intussusception was corrected with a barium enema and the child was released from the hospital. The patient recovered. No other information was available. Intussusception was considered to be immediately life-threatening and an other important medical event by the reporter. Additional information has been requested. 8/27/07-records received for DOS-7/22/07-DX: Intussusception. Reduced with Barium enema. C/O abdominal pain since toady 7/22/07-Cranky, crying, waking up. No fever. No vomiting. No diarrhea. No rash.


Changed on 5/14/2017

VAERS ID: 286188 Before After
VAERS Form:
Age:0.5
Gender:Male
Location:New Jersey
Vaccinated:2007-03-24
Onset:2007-07-22
Submitted:2007-07-27
Entered:2007-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1239F / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Crying, Intussusception, Urinary system X-ray, Enema administration, Ultrasound abdomen abnormal, Poor quality sleep

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: barium enema X-ray - IT corrected 8/27/07-records received-Xray KUB: stool filled colon. US abdomen: RUQ intussusception. Fluoroscopically guided air enema reduced intussusception. PMH: pylonmyotomy at 5 weeks for pyloric stenosis. Labs: n neutrophils 71.0, lymphs 18.0, glucose 112, total bilirubin 0.9.
CDC 'Split Type': WAES0707USA04056

Write-up: Information has been received from a registered nurse concerning a 10-month-old male who on 13-NOV-2006, 12-JAN-2007, and 24-MAR-2007 was vaccinated with the first, second, and third doses of Rotateq. On 22-JUL-2007 the patient experienced intussusception and was hospitalized. The intussusception was corrected with a barium enema and the child was released from the hospital. The patient recovered. No other information was available. Intussusception was considered to be immediately life-threatening and an other important medical event by the reporter. Additional information has been requested. 8/27/07-records received for DOS-7/22/07-DX: Intussusception. Reduced with Barium enema. C/O abdominal pain since toady 7/22/07-Cranky, crying, waking up. No fever. No vomiting. No diarrhea. No rash.


Changed on 9/14/2017

VAERS ID: 286188 Before After
VAERS Form:(blank) 1
Age:0.5
Gender:Male
Location:New Jersey
Vaccinated:2007-03-24
Onset:2007-07-22
Submitted:2007-07-27
Entered:2007-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1239F / 2 3 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Enema administration

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: barium enema X-ray - IT corrected 8/27/07-records received-Xray KUB: stool filled colon. US abdomen: RUQ intussusception. Fluoroscopically guided air enema reduced intussusception. PMH: pylonmyotomy at 5 weeks for pyloric stenosis. Labs: neutrophils 71.0, lymphs 18.0, glucose 112, total bilirubin 0.9.
CDC 'Split Type': WAES0707USA04056

Write-up: Information has been received from a registered nurse concerning a 10-month-old male who on 13-NOV-2006, 12-JAN-2007, and 24-MAR-2007 was vaccinated with the first, second, and third doses of Rotateq. On 22-JUL-2007 the patient experienced intussusception and was hospitalized. The intussusception was corrected with a barium enema and the child was released from the hospital. The patient recovered. No other information was available. Intussusception was considered to be immediately life-threatening and an other important medical event by the reporter. Additional information has been requested. 8/27/07-records received for DOS-7/22/07-DX: Intussusception. Reduced with Barium enema. C/O abdominal pain since toady 7/22/07-Cranky, crying, waking up. No fever. No vomiting. No diarrhea. No rash.


Changed on 2/14/2018

VAERS ID: 286188 Before After
VAERS Form:1
Age:0.5
Gender:Male
Location:New Jersey
Vaccinated:2007-03-24
Onset:2007-07-22
Submitted:2007-07-27
Entered:2007-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1239F / 3 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Enema administration

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: barium enema X-ray - IT corrected 8/27/07-records received-Xray KUB: stool filled colon. US abdomen: RUQ intussusception. Fluoroscopically guided air enema reduced intussusception. PMH: pylonmyotomy at 5 weeks for pyloric stenosis. Labs: neutrophils 71.0, lymphs 18.0, glucose 112, total bilirubin 0.9.
CDC 'Split Type': WAES0707USA04056

Write-up: Information has been received from a registered nurse concerning a 10-month-old male who on 13-NOV-2006, 12-JAN-2007, and 24-MAR-2007 was vaccinated with the first, second, and third doses of Rotateq. On 22-JUL-2007 the patient experienced intussusception and was hospitalized. The intussusception was corrected with a barium enema and the child was released from the hospital. The patient recovered. No other information was available. Intussusception was considered to be immediately life-threatening and an other important medical event by the reporter. Additional information has been requested. 8/27/07-records received for DOS-7/22/07-DX: Intussusception. Reduced with Barium enema. C/O abdominal pain since toady 7/22/07-Cranky, crying, waking up. No fever. No vomiting. No diarrhea. No rash.


Changed on 6/14/2018

VAERS ID: 286188 Before After
VAERS Form:1
Age:0.5
Gender:Male
Location:New Jersey
Vaccinated:2007-03-24
Onset:2007-07-22
Submitted:2007-07-27
Entered:2007-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1239F / 3 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Enema administration

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: barium enema X-ray - IT corrected 8/27/07-records received-Xray KUB: stool filled colon. US abdomen: RUQ intussusception. Fluoroscopically guided air enema reduced intussusception. PMH: pylonmyotomy at 5 weeks for pyloric stenosis. Labs: neutrophils 71.0, lymphs 18.0, glucose 112, total bilirubin 0.9.
CDC 'Split Type': WAES0707USA04056

Write-up: Information has been received from a registered nurse concerning a 10-month-old male who on 13-NOV-2006, 12-JAN-2007, and 24-MAR-2007 was vaccinated with the first, second, and third doses of Rotateq. On 22-JUL-2007 the patient experienced intussusception and was hospitalized. The intussusception was corrected with a barium enema and the child was released from the hospital. The patient recovered. No other information was available. Intussusception was considered to be immediately life-threatening and an other important medical event by the reporter. Additional information has been requested. 8/27/07-records received for DOS-7/22/07-DX: Intussusception. Reduced with Barium enema. C/O abdominal pain since toady 7/22/07-Cranky, crying, waking up. No fever. No vomiting. No diarrhea. No rash.

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