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This is VAERS ID 288141

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 288141
VAERS Form:
Age:
Gender:Unknown
Location:New York
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-08-14
Entered:2007-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 2 UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Intussusception

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up: Information has been received from a physician concerning a patient who was vaccinated with a third dose of Rotateq. Subsequently, 4 weeks after the third dose, the patient developed intussusception. It was noted that the patient''''s chart was not at the o"ffice so no further data was available at the time of the report. Upon internal review, the patient''''s intussusception was considered to be an other important medical event. Additional information has been requested.


Changed on 12/8/2009

VAERS ID: 288141 Before After
VAERS Form:
Age:
Gender:Unknown
Location:New York
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-08-14
Entered:2007-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 2 UN / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Intussusception

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0708USA00165

Write-up: Information has been received from a physician concerning a patient who was vaccinated with a third dose of Rotateq. Subsequently, 4 weeks after the third dose, the patient developed intussusception. It was noted that the patient''''s patient''s chart was not at the o"ffice office so no further data was available at the time of the report. Upon internal review, the patient''''s patient''s intussusception was considered to be an other important medical event. Additional information has been requested.


Changed on 5/13/2013

VAERS ID: 288141 Before After
VAERS Form:
Age:
Gender:Unknown
Location:New York
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-08-14
Entered:2007-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 2 UN / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Intussusception

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0708USA00165

Write-up: Information has been received from a physician concerning a patient who was vaccinated with a third dose of Rotateq. Subsequently, 4 weeks after the third dose, the patient developed intussusception. It was noted that the patient''s chart was not at the office so no further data was available at the time of the report. Upon internal review, the patient''s intussusception was considered to be an other important medical event. Additional information has been requested.


Changed on 6/14/2014

VAERS ID: 288141 Before After
VAERS Form:
Age:
Gender:Unknown
Location:New York
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-08-14
Entered:2007-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Intussusception

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0708USA00165

Write-up: Information has been received from a physician concerning a patient who was vaccinated with a third dose of Rotateq. Subsequently, 4 weeks after the third dose, the patient developed intussusception. It was noted that the patient''s chart was not at the office so no further data was available at the time of the report. Upon internal review, the patient''s intussusception was considered to be an other important medical event. Additional information has been requested.


Changed on 5/14/2017

VAERS ID: 288141 Before After
VAERS Form:
Age:
Gender:Unknown
Location:New York
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-08-14
Entered:2007-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Intussusception

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0708USA00165

Write-up: Information has been received from a physician concerning a patient who was vaccinated with a third dose of Rotateq. Subsequently, 4 weeks after the third dose, the patient developed intussusception. It was noted that the patient''s chart was not at the office so no further data was available at the time of the report. Upon internal review, the patient''s intussusception was considered to be an other important medical event. Additional information has been requested.


Changed on 9/14/2017

VAERS ID: 288141 Before After
VAERS Form:(blank) 1
Age:
Gender:Unknown
Location:New York
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-08-14
Entered:2007-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 2 3 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Intussusception

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0708USA00165

Write-up: Information has been received from a physician concerning a patient who was vaccinated with a third dose of Rotateq. Subsequently, 4 weeks after the third dose, the patient developed intussusception. It was noted that the patient''s chart was not at the office so no further data was available at the time of the report. Upon internal review, the patient''s intussusception was considered to be an other important medical event. Additional information has been requested.


Changed on 2/14/2018

VAERS ID: 288141 Before After
VAERS Form:1
Age:
Gender:Unknown
Location:New York
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-08-14
Entered:2007-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 3 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Intussusception

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0708USA00165

Write-up: Information has been received from a physician concerning a patient who was vaccinated with a third dose of Rotateq. Subsequently, 4 weeks after the third dose, the patient developed intussusception. It was noted that the patient''s chart was not at the office so no further data was available at the time of the report. Upon internal review, the patient''s intussusception was considered to be an other important medical event. Additional information has been requested.


Changed on 6/14/2018

VAERS ID: 288141 Before After
VAERS Form:1
Age:
Gender:Unknown
Location:New York
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-08-14
Entered:2007-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 3 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Intussusception

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0708USA00165

Write-up: Information has been received from a physician concerning a patient who was vaccinated with a third dose of Rotateq. Subsequently, 4 weeks after the third dose, the patient developed intussusception. It was noted that the patient''s chart was not at the office so no further data was available at the time of the report. Upon internal review, the patient''s intussusception was considered to be an other important medical event. Additional information has been requested.


Changed on 8/14/2018

VAERS ID: 288141 Before After
VAERS Form:1
Age:
Gender:Unknown
Location:New York
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-08-14
Entered:2007-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 3 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Intussusception

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0708USA00165

Write-up: Information has been received from a physician concerning a patient who was vaccinated with a third dose of Rotateq. Subsequently, 4 weeks after the third dose, the patient developed intussusception. It was noted that the patient''s chart was not at the office so no further data was available at the time of the report. Upon internal review, the patient''s intussusception was considered to be an other important medical event. Additional information has been requested.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=288141&WAYBACKHISTORY=ON


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