![]() |
National Vaccine Information Center Your Health. Your Family. Your Choice. |
MedAlerts Home |
History of Changes from the VAERS Wayback Machine |
VAERS ID: | 291938 |
VAERS Form: | |
Age: | 0.4 |
Sex: | Male |
Location: | Kansas |
Vaccinated: | 2007-08-20 |
Onset: | 2007-09-18 |
Submitted: | 2007-10-02 |
Entered: | 2007-10-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0875U / 1 | UN / UN |
Administered by: Other Purchased by: Unknown
Symptoms: Haematochezia, Intussusception, Vomiting, Enema administration
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1
Write-up: Information has been received from a physician concerning a male infant who at a 4 month old visit was vaccinated with his second dose of Rotateq and later experienced intussusception. Unspecified medical attention was sought. The patient''''s recovery stat"us was unknown. There was no product quality complaint. Upon internal review, intussusception was determined to be an other important medical event. Additional information has been requested.
Vaccinated: | 2007-08-20 |
Onset: | 2007-09-18 |
Submitted: | 2007-10-02 |
Entered: | 2007-10-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0875U / 1 | UN / UN |
Administered by: Other Purchased by: Unknown Other
Symptoms: Haematochezia, Intussusception, Vomiting, Enema administration
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1
Write-up: Information has been received from a physician concerning a male infant who at a 4 month old visit was vaccinated with his second dose of Rotateq and later experienced intussusception. Unspecified medical attention was sought. The patient''''s patient''s recovery stat"us status was unknown. There was no product quality complaint. Upon internal review, intussusception was determined to be an other important medical event. Additional information has been requested. 11/6/07-records received for DOS 9/19-9/20/07-intussusception reduced by air enema. History of bloody stools and emesis. Observed after procedure, tolerated breast feeding, discharged.
Vaccinated: | 2007-08-20 |
Onset: | 2007-09-18 |
Submitted: | 2007-10-02 |
Entered: | 2007-10-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0875U / 1 | UN / UN |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0875U / 1 | UN / UN |
Administered by: Other Purchased by: Other
Symptoms: Haematochezia, Intussusception, Vomiting, Enema administration
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1
Write-up: Information has been received from a physician concerning a male infant who at a 4 month old visit was vaccinated with his second dose of Rotateq and later experienced intussusception. Unspecified medical attention was sought. The patient''s recovery status was unknown. There was no product quality complaint. Upon internal review, intussusception was determined to be an other important medical event. Additional information has been requested. 11/6/07-records received for DOS 9/19-9/20/07-intussusception reduced by air enema. History of bloody stools and emesis. Observed after procedure, tolerated breast feeding, discharged.
Vaccinated: | 2007-08-20 |
Onset: | 2007-09-18 |
Submitted: | 2007-10-02 |
Entered: | 2007-10-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0875U / 1 | UN / UN |
Administered by: Other Purchased by: Other
Symptoms: Haematochezia, Intussusception, Vomiting, Enema administration
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1
Write-up: Information has been received from a physician concerning a male infant who at a 4 month old visit was vaccinated with his second dose of Rotateq and later experienced intussusception. Unspecified medical attention was sought. The patient''s recovery status was unknown. There was no product quality complaint. Upon internal review, intussusception was determined to be an other important medical event. Additional information has been requested. 11/6/07-records received for DOS 9/19-9/20/07-intussusception reduced by air enema. History of bloody stools and emesis. Observed after procedure, tolerated breast feeding, discharged.
Vaccinated: | 2007-08-20 |
Onset: | 2007-09-18 |
Submitted: | 2007-10-02 |
Entered: | 2007-10-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0875U / 1 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1
Write-up: Information has been received from a physician concerning a male infant who at a 4 month old visit was vaccinated with his second dose of Rotateq and later experienced intussusception. Unspecified medical attention was sought. The patient''s recovery status was unknown. There was no product quality complaint. Upon internal review, intussusception was determined to be an other important medical event. Additional information has been requested. 11/6/07-records received for DOS 9/19-9/20/07-intussusception reduced by air enema. History of bloody stools and emesis. Observed after procedure, tolerated breast feeding, discharged.
Vaccinated: | 2007-08-20 |
Onset: | 2007-09-18 |
Submitted: | 2007-10-02 |
Entered: | 2007-10-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0875U / 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1
Write-up: Information has been received from a physician concerning a male infant who at a 4 month old visit was vaccinated with his second dose of Rotateq and later experienced intussusception. Unspecified medical attention was sought. The patient''s recovery status was unknown. There was no product quality complaint. Upon internal review, intussusception was determined to be an other important medical event. Additional information has been requested. 11/6/07-records received for DOS 9/19-9/20/07-intussusception reduced by air enema. History of bloody stools and emesis. Observed after procedure, tolerated breast feeding, discharged.
Vaccinated: | 2007-08-20 |
Onset: | 2007-09-18 |
Submitted: | 2007-10-02 |
Entered: | 2007-10-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0875U / 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1
Write-up: Information has been received from a physician concerning a male infant who at a 4 month old visit was vaccinated with his second dose of Rotateq and later experienced intussusception. Unspecified medical attention was sought. The patient''s recovery status was unknown. There was no product quality complaint. Upon internal review, intussusception was determined to be an other important medical event. Additional information has been requested. 11/6/07-records received for DOS 9/19-9/20/07-intussusception reduced by air enema. History of bloody stools and emesis. Observed after procedure, tolerated breast feeding, discharged.
Vaccinated: | 2007-08-20 |
Onset: | 2007-09-18 |
Submitted: | 2007-10-02 |
Entered: | 2007-10-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0875U / 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1
Write-up: Information has been received from a physician concerning a male infant who at a 4 month old visit was vaccinated with his second dose of Rotateq and later experienced intussusception. Unspecified medical attention was sought. The patient''s recovery status was unknown. There was no product quality complaint. Upon internal review, intussusception was determined to be an other important medical event. Additional information has been requested. 11/6/07-records received for DOS 9/19-9/20/07-intussusception reduced by air enema. History of bloody stools and emesis. Observed after procedure, tolerated breast feeding, discharged.
Vaccinated: | 2007-08-20 |
Onset: | 2007-09-18 |
Submitted: | 2007-10-02 |
Entered: | 2007-10-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0875U / 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1
Write-up: Information has been received from a physician concerning a male infant who at a 4 month old visit was vaccinated with his second dose of Rotateq and later experienced intussusception. Unspecified medical attention was sought. The patient''s recovery status was unknown. There was no product quality complaint. Upon internal review, intussusception was determined to be an other important medical event. Additional information has been requested. 11/6/07-records received for DOS 9/19-9/20/07-intussusception reduced by air enema. History of bloody stools and emesis. Observed after procedure, tolerated breast feeding, discharged.
Vaccinated: | 2007-08-20 |
Onset: | 2007-09-18 |
Submitted: | 2007-10-02 |
Entered: | 2007-10-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0875U / 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1
Write-up: Information has been received from a physician concerning a male infant who at a 4 month old visit was vaccinated with his second dose of Rotateq and later experienced intussusception. Unspecified medical attention was sought. The patient''s recovery status was unknown. There was no product quality complaint. Upon internal review, intussusception was determined to be an other important medical event. Additional information has been requested. 11/6/07-records received for DOS 9/19-9/20/07-intussusception reduced by air enema. History of bloody stools and emesis. Observed after procedure, tolerated breast feeding, discharged.
Vaccinated: | 2007-08-20 |
Onset: | 2007-09-18 |
Submitted: | 2007-10-02 |
Entered: | 2007-10-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0875U / 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1
Write-up: Information has been received from a physician concerning a male infant who at a 4 month old visit was vaccinated with his second dose of Rotateq and later experienced intussusception. Unspecified medical attention was sought. The patient''s recovery status was unknown. There was no product quality complaint. Upon internal review, intussusception was determined to be an other important medical event. Additional information has been requested. 11/6/07-records received for DOS 9/19-9/20/07-intussusception reduced by air enema. History of bloody stools and emesis. Observed after procedure, tolerated breast feeding, discharged.
Vaccinated: | 2007-08-20 |
Onset: | 2007-09-18 |
Submitted: | 2007-10-02 |
Entered: | 2007-10-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0875U / 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1
Write-up: Information has been received from a physician concerning a male infant who at a 4 month old visit was vaccinated with his second dose of Rotateq and later experienced intussusception. Unspecified medical attention was sought. The patient''s recovery status was unknown. There was no product quality complaint. Upon internal review, intussusception was determined to be an other important medical event. Additional information has been requested. 11/6/07-records received for DOS 9/19-9/20/07-intussusception reduced by air enema. History of bloody stools and emesis. Observed after procedure, tolerated breast feeding, discharged.
Link To This Search Result:
https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=291938&WAYBACKHISTORY=ON
Copyright ©
2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166