National Vaccine
Information Center
Your Health. Your Family. Your Choice.

 MedAlerts Home
Search Results

This is VAERS ID 291861

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 291861
VAERS Form:
Age:0.4
Gender:Male
Location:Tennessee
Vaccinated:2007-09-17
Onset:2007-09-30
Submitted:2007-10-02
Entered:2007-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0876U / 1 UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Appendicectomy, Computerised tomogram, Haematochezia, 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: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: KUB, CT abdomen, Air enema
CDC 'Split Type':

Write-up: Intussusception

Changed on 12/8/2009

VAERS ID: 291861 Before After
VAERS Form:
Age:0.4
Gender:Male
Location:Tennessee
Vaccinated:2007-09-17
Onset:2007-09-30
Submitted:2007-10-02
Entered:2007-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0876U / 1 UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Appendicectomy, Computerised tomogram, Haematochezia, Intussusception, Laparotomy, Urinary system X-ray, Vomiting, 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: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: KUB, CT abdomen, Air enema 10/15/07-records received-10/15/07-records received for DOS 10/1/07-DX Intussusception. Presented to ED with vomiting and bloody stools last 2 days. Onset abrupt. Exploratory laparotomy with reduction of intussus
CDC 'Split Type':

Write-up: Intussusception 10/15/07-records received for DOS 10/1/07-DX Intussusception. Presented to ED with vomiting and bloody stools last 2 days. Onset abrupt. Exploratory laparotomy with reduction of intussusception and incidental appendectomy. Therapeutic enema with air contrast unsuccessful in reduction of intussusception beyond the level of ileocecal.

Changed on 1/5/2010

VAERS ID: 291861 Before After
VAERS Form:
Age:0.4
Gender:Male
Location:Tennessee
Vaccinated:2007-09-17
Onset:2007-09-30
Submitted:2007-10-02
Entered:2007-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0876U / 1 UN / UN

Administered by: Unknown Public      Purchased by: Unknown Public
Symptoms: Appendicectomy, Computerised tomogram, Haematochezia, Intussusception, Laparotomy, Urinary system X-ray, Vomiting, 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: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: KUB, CT abdomen, Air enema 10/15/07-records received-10/15/07-records received for DOS 10/1/07-DX Intussusception. Presented to ED with vomiting and bloody stools last 2 days. Onset abrupt. Exploratory laparotomy with reduction of intussus
CDC 'Split Type':

Write-up: Intussusception 10/15/07-records received for DOS 10/1/07-DX Intussusception. Presented to ED with vomiting and bloody stools last 2 days. Onset abrupt. Exploratory laparotomy with reduction of intussusception and incidental appendectomy. Therapeutic enema with air contrast unsuccessful in reduction of intussusception beyond the level of ileocecal. Follow-up Information 02-OCT-2007: Intussusception treated with surgery

Changed on 1/4/2011

VAERS ID: 291861 Before After
VAERS Form:
Age:0.4
Gender:Male
Location:Tennessee
Vaccinated:2007-09-17
Onset:2007-09-30
Submitted:2007-10-02
Entered:2007-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0876U / 1 UN / UN

Administered by: Public      Purchased by: Public
Symptoms: Computerised tomogram, Intussusception, Urinary system X-ray, 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: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: KUB, CT abdomen, Air enema 10/15/07-records received-10/15/07-records received for DOS 10/1/07-DX Intussusception. Presented to ED with vomiting and bloody stools last 2 days. Onset abrupt. Exploratory laparotomy with reduction of intussus intussusception and incidental appendectomy. Therapeutic enema with air contrast unsuccessful in reduction of intussusception beyond the level of ileocecal. KUB, CT scan, air enema
CDC 'Split Type':

Write-up: Intussusception 10/15/07-records received for DOS 10/1/07-DX Intussusception. Presented to ED with vomiting and bloody stools last 2 days. Onset abrupt. Exploratory laparotomy with reduction of intussusception and incidental appendectomy. Therapeutic enema with air contrast unsuccessful in reduction of intussusception beyond the level of ileocecal. Follow-up Information 02-OCT-2007: Intussusception treated with surgery

Changed on 4/13/2011

VAERS ID: 291861 Before After
VAERS Form:
Age:0.4
Gender:Male
Location:Tennessee
Vaccinated:2007-09-17
Onset:2007-09-30
Submitted:2007-10-02
Entered:2007-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0876U / 1 UN / UN

Administered by: Public      Purchased by: Public
Symptoms: Appendicectomy, Computerised tomogram, Haematochezia, Intussusception, Laparotomy, Urinary system X-ray, Vomiting, 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: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: KUB, CT abdomen, Air enema 10/15/07-records received-10/15/07-records received for DOS 10/1/07-DX Intussusception. Presented to ED with vomiting and bloody stools last 2 days. Onset abrupt. Exploratory laparotomy with reduction of intussusception and incidental appendectomy. Therapeutic enema with air contrast unsuccessful in reduction of intussusception beyond the level of ileocecal. KUB, CT scan, air enema
CDC 'Split Type':

Write-up: Intussusception 10/15/07-records received for DOS 10/1/07-DX Intussusception. Presented to ED with vomiting and bloody stools last 2 days. Onset abrupt. Exploratory laparotomy with reduction of intussusception and incidental appendectomy. Therapeutic enema with air contrast unsuccessful in reduction of intussusception beyond the level of ileocecal. Follow-up Information 02-OCT-2007: Intussusception treated with surgery

Changed on 5/13/2011

VAERS ID: 291861 Before After
VAERS Form:
Age:0.4
Gender:Male
Location:Tennessee
Vaccinated:2007-09-17
Onset:2007-09-30
Submitted:2007-10-02
Entered:2007-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0876U / 1 UN / UN

Administered by: Public      Purchased by: Public
Symptoms: Appendicectomy, Computerised tomogram, Haematochezia, Intussusception, Laparotomy, Urinary system X-ray, Vomiting, 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: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: KUB, CT abdomen, Air enema 10/15/07-records received-10/15/07-records received for DOS 10/1/07-DX Intussusception. Presented to ED with vomiting and bloody stools last 2 days. Onset abrupt. Exploratory laparotomy with reduction of intussusception and incidental appendectomy. Therapeutic enema with air contrast unsuccessful in reduction of intussusception beyond the level of ileocecal. KUB, CT scan, air enema
CDC 'Split Type':

Write-up: Intussusception 10/15/07-records received for DOS 10/1/07-DX Intussusception. Presented to ED with vomiting and bloody stools last 2 days. Onset abrupt. Exploratory laparotomy with reduction of intussusception and incidental appendectomy. Therapeutic enema with air contrast unsuccessful in reduction of intussusception beyond the level of ileocecal. Follow-up Information 02-OCT-2007: Intussusception treated with surgery

Changed on 6/11/2011

VAERS ID: 291861 Before After
VAERS Form:
Age:0.4
Gender:Male
Location:Tennessee
Vaccinated:2007-09-17
Onset:2007-09-30
Submitted:2007-10-02
Entered:2007-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0876U / 1 UN / UN

Administered by: Public      Purchased by: Public
Symptoms: Appendicectomy, Computerised tomogram, Haematochezia, Intussusception, Laparotomy, Urinary system X-ray, Vomiting, 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: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: KUB, CT abdomen, Air enema 10/15/07-records received-10/15/07-records received for DOS 10/1/07-DX Intussusception. Presented to ED with vomiting and bloody stools last 2 days. Onset abrupt. Exploratory laparotomy with reduction of intussusception and incidental appendectomy. Therapeutic enema with air contrast unsuccessful in reduction of intussusception beyond the level of ileocecal. KUB, CT scan, air enema
CDC 'Split Type':

Write-up: Intussusception 10/15/07-records received for DOS 10/1/07-DX Intussusception. Presented to ED with vomiting and bloody stools last 2 days. Onset abrupt. Exploratory laparotomy with reduction of intussusception and incidental appendectomy. Therapeutic enema with air contrast unsuccessful in reduction of intussusception beyond the level of ileocecal. Follow-up Information 02-OCT-2007: Intussusception treated with surgery

Changed on 5/13/2013

VAERS ID: 291861 Before After
VAERS Form:
Age:0.4
Gender:Male
Location:Tennessee
Vaccinated:2007-09-17
Onset:2007-09-30
Submitted:2007-10-02
Entered:2007-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0876U / 1 UN / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0876U / 1 UN / UN

Administered by: Public      Purchased by: Public
Symptoms: Appendicectomy, Computerised tomogram, Haematochezia, Intussusception, Laparotomy, Urinary system X-ray, Vomiting, 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: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: KUB, CT abdomen, Air enema 10/15/07-records received-10/15/07-records received for DOS 10/1/07-DX Intussusception. Presented to ED with vomiting and bloody stools last 2 days. Onset abrupt. Exploratory laparotomy with reduction of intussusception and incidental appendectomy. Therapeutic enema with air contrast unsuccessful in reduction of intussusception beyond the level of ileocecal. KUB, CT scan, air enema
CDC 'Split Type':

Write-up: Intussusception 10/15/07-records received for DOS 10/1/07-DX Intussusception. Presented to ED with vomiting and bloody stools last 2 days. Onset abrupt. Exploratory laparotomy with reduction of intussusception and incidental appendectomy. Therapeutic enema with air contrast unsuccessful in reduction of intussusception beyond the level of ileocecal. Follow-up Information 02-OCT-2007: Intussusception treated with surgery

Changed on 6/14/2014

VAERS ID: 291861 Before After
VAERS Form:
Age:0.4
Gender:Male
Location:Tennessee
Vaccinated:2007-09-17
Onset:2007-09-30
Submitted:2007-10-02
Entered:2007-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0876U / 1 UN / UN

Administered by: Public      Purchased by: Public
Symptoms: Appendicectomy, Computerised tomogram, Haematochezia, Intussusception, Laparotomy, Urinary system X-ray, Vomiting, 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: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: KUB, CT abdomen, Air enema 10/15/07-records received-10/15/07-records received for DOS 10/1/07-DX Intussusception. Presented to ED with vomiting and bloody stools last 2 days. Onset abrupt. Exploratory laparotomy with reduction of intussusception and incidental appendectomy. Therapeutic enema with air contrast unsuccessful in reduction of intussusception beyond the level of ileocecal. KUB, CT scan, air enema
CDC 'Split Type':

Write-up: Intussusception 10/15/07-records received for DOS 10/1/07-DX Intussusception. Presented to ED with vomiting and bloody stools last 2 days. Onset abrupt. Exploratory laparotomy with reduction of intussusception and incidental appendectomy. Therapeutic enema with air contrast unsuccessful in reduction of intussusception beyond the level of ileocecal. Follow-up Information 02-OCT-2007: Intussusception treated with surgery

Changed on 2/14/2017

VAERS ID: 291861 Before After
VAERS Form:
Age:0.4 0.39
Gender:Male
Location:Tennessee
Vaccinated:2007-09-17
Onset:2007-09-30
Submitted:2007-10-02
Entered:2007-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0876U / 1 UN / UN

Administered by: Public      Purchased by: Public
Symptoms: Appendicectomy, Computerised tomogram, Haematochezia, Intussusception, Laparotomy, Urinary system X-ray, Vomiting, 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: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: KUB, CT abdomen, Air enema 10/15/07-records received-10/15/07-records received for DOS 10/1/07-DX Intussusception. Presented to ED with vomiting and bloody stools last 2 days. Onset abrupt. Exploratory laparotomy with reduction of intussusception and incidental appendectomy. Therapeutic enema with air contrast unsuccessful in reduction of intussusception beyond the level of ileocecal. KUB, CT scan, air enema
CDC 'Split Type':

Write-up: Intussusception 10/15/07-records received for DOS 10/1/07-DX Intussusception. Presented to ED with vomiting and bloody stools last 2 days. Onset abrupt. Exploratory laparotomy with reduction of intussusception and incidental appendectomy. Therapeutic enema with air contrast unsuccessful in reduction of intussusception beyond the level of ileocecal. Follow-up Information 02-OCT-2007: Intussusception treated with surgery

Changed on 4/14/2017

VAERS ID: 291861 Before After
VAERS Form:
Age:0.39
Gender:Male
Location:Tennessee
Vaccinated:2007-09-17
Onset:2007-09-30
Submitted:2007-10-02
Entered:2007-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0876U / 1 UN / UN

Administered by: Public      Purchased by: Public
Symptoms: Appendicectomy, Computerised tomogram, Haematochezia, Intussusception, Laparotomy, Urinary system X-ray, Vomiting, 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: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: KUB, CT abdomen, Air enema 10/15/07-records received-10/15/07-records received for DOS 10/1/07-DX Intussusception. Presented to ED with vomiting and bloody stools last 2 days. Onset abrupt. Exploratory laparotomy with reduction of intussusception and incidental appendectomy. Therapeutic enema with air contrast unsuccessful in reduction of intussusception beyond the level of ileocecal. KUB, CT scan, air enema
CDC 'Split Type':

Write-up: Intussusception 10/15/07-records received for DOS 10/1/07-DX Intussusception. Presented to ED with vomiting and bloody stools last 2 days. Onset abrupt. Exploratory laparotomy with reduction of intussusception and incidental appendectomy. Therapeutic enema with air contrast unsuccessful in reduction of intussusception beyond the level of ileocecal. Follow-up Information 02-OCT-2007: Intussusception treated with surgery

Changed on 9/14/2017

VAERS ID: 291861 Before After
VAERS Form:(blank) 1
Age:0.39
Gender:Male
Location:Tennessee
Vaccinated:2007-09-17
Onset:2007-09-30
Submitted:2007-10-02
Entered:2007-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0876U / 1 2 UN / UN

Administered by: Public      Purchased by: Public
Symptoms: Computerised tomogram, Intussusception, Urinary system X-ray, 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: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: KUB, CT abdomen, Air enema 10/15/07-records received-10/15/07-records received for DOS 10/1/07-DX Intussusception. Presented to ED with vomiting and bloody stools last 2 days. Onset abrupt. Exploratory laparotomy with reduction of intussusception and incidental appendectomy. Therapeutic enema with air contrast unsuccessful in reduction of intussusception beyond the level of ileocecal. KUB, CT scan, air enema
CDC 'Split Type':

Write-up: Intussusception 10/15/07-records received for DOS 10/1/07-DX Intussusception. Presented to ED with vomiting and bloody stools last 2 days. Onset abrupt. Exploratory laparotomy with reduction of intussusception and incidental appendectomy. Therapeutic enema with air contrast unsuccessful in reduction of intussusception beyond the level of ileocecal. Follow-up Information 02-OCT-2007: Intussusception treated with surgery

Changed on 2/14/2018

VAERS ID: 291861 Before After
VAERS Form:1
Age:0.39
Gender:Male
Location:Tennessee
Vaccinated:2007-09-17
Onset:2007-09-30
Submitted:2007-10-02
Entered:2007-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0876U / 2 UN / UN

Administered by: Public      Purchased by: Public
Symptoms: Computerised tomogram, Intussusception, Urinary system X-ray, 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: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: KUB, CT abdomen, Air enema 10/15/07-records received-10/15/07-records received for DOS 10/1/07-DX Intussusception. Presented to ED with vomiting and bloody stools last 2 days. Onset abrupt. Exploratory laparotomy with reduction of intussusception and incidental appendectomy. Therapeutic enema with air contrast unsuccessful in reduction of intussusception beyond the level of ileocecal. KUB, CT scan, air enema
CDC 'Split Type':

Write-up: Intussusception 10/15/07-records received for DOS 10/1/07-DX Intussusception. Presented to ED with vomiting and bloody stools last 2 days. Onset abrupt. Exploratory laparotomy with reduction of intussusception and incidental appendectomy. Therapeutic enema with air contrast unsuccessful in reduction of intussusception beyond the level of ileocecal. Follow-up Information 02-OCT-2007: Intussusception treated with surgery

New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=291861&WAYBACKHISTORY=ON


Copyright © 2018 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166