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VAERS ID: | 293275 |
VAERS Form: | |
Age: | 0.3 |
Gender: | Male |
Location: | New Mexico |
Vaccinated: | 2007-09-12 |
Onset: | 2007-09-27 |
Submitted: | 2007-10-15 |
Entered: | 2007-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHE: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B11UAB / 1 | LL / - |
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER | 0078U / 1 | LL / - |
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC | B265108 / 1 | RL / - |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0770U / 1 | - / PO |
Administered by: Other Purchased by: Unknown
Symptoms: Barium enema, Computerised tomogram abnormal, Haematochezia, Fontanelle depressed, Gastrointestinal sounds abnormal
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
Write-up: Information has been received from a physician concerning a male who on 11-SEP-2007 was vaccinated with a second oral dose of Rotateq. Concomitant therapy included sulfamethoxazole/trimethoprim (BACTRIM) for an ear infection. Subsequently the patient expe"rienced intussusception. The patient was taken to the emergency room and was treated with an air enema reduction. It was reported that the patient recovered. The patient''''s intussusception was considered to be immediately life-threatening by the reporter.
Vaccinated: | 2007-09-12 |
Onset: | 2007-09-27 |
Submitted: | 2007-10-15 |
Entered: | 2007-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHE: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B11UAB / 1 | LL / - |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B11UAB / 1 | LL / - |
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER | 0078U / 1 | LL / - |
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC | B265108 / 1 | RL / - |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0770U / 1 | - / PO |
Administered by: Other Purchased by: Unknown Other
Symptoms: Barium enema, Computerised tomogram abnormal, Haematochezia, Hypersomnia, Intussusception, Lethargy, Lymphadenopathy, Vomiting, Fontanelle depressed, Gastrointestinal sounds abnormal
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
Write-up: Information has been received from a physician concerning a male who on 11-SEP-2007 was vaccinated with a second oral dose of Rotateq. Concomitant therapy included sulfamethoxazole/trimethoprim (BACTRIM) for an ear infection. Subsequently the patient expe"rienced experienced intussusception. The patient was taken to the emergency room and was treated with an air enema reduction. It was reported that the patient recovered. The patient''''s patient''s intussusception was considered to be immediately life-threatening by the reporter. Additional information has been requested. 10/18/2007 Vax record recieved and info updated in VAERS database. 10/30/2007 MR received for hospital DOS 9/27-30/2007 for D/C DX of Reduced Intussusception on air enema. Infant presented to the ER with intractable vomiting and dark, bloody bowel movements as well as excessive sleep. PE (+) for lack of bowel sounds, lethargy, and depressed fontenelle. (+) Currant jelly stool in ER. Barium enema successfuly reduced IS.
Vaccinated: | 2007-09-12 |
Onset: | 2007-09-27 |
Submitted: | 2007-10-15 |
Entered: | 2007-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B11UAB / 1 | LL / - |
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER | 0078U / 1 | LL / - |
PNC: PNEUMO (PREVNAR) PNEUMO (PREVNAR7) / WYETH PHARMACEUTICALS, INC | B265108 / 1 | RL / - |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0770U / 1 | - / PO |
Administered by: Other Purchased by: Other
Symptoms: Barium enema, Computerised tomogram abnormal, Haematochezia, Hypersomnia, Intussusception, Lethargy, Lymphadenopathy, Vomiting, Fontanelle depressed, Gastrointestinal sounds abnormal
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
Write-up: Information has been received from a physician concerning a male who on 11-SEP-2007 was vaccinated with a second oral dose of Rotateq. Concomitant therapy included sulfamethoxazole/trimethoprim (BACTRIM) for an ear infection. Subsequently the patient experienced intussusception. The patient was taken to the emergency room and was treated with an air enema reduction. It was reported that the patient recovered. The patient''s intussusception was considered to be immediately life-threatening by the reporter. Additional information has been requested. 10/18/2007 Vax record recieved and info updated in VAERS database. 10/30/2007 MR received for hospital DOS 9/27-30/2007 for D/C DX of Reduced Intussusception on air enema. Infant presented to the ER with intractable vomiting and dark, bloody bowel movements as well as excessive sleep. PE (+) for lack of bowel sounds, lethargy, and depressed fontenelle. (+) Currant jelly stool in ER. Barium enema successfuly reduced IS.
Vaccinated: | 2007-09-12 |
Onset: | 2007-09-27 |
Submitted: | 2007-10-15 |
Entered: | 2007-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B11UAB / 1 | LL / - |
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER | 0078U / 1 | LL / - |
PNC: PNEUMO (PREVNAR7) PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC | B265108 / 1 | RL / - |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0770U / 1 | - / PO |
Administered by: Other Purchased by: Other
Symptoms: Barium enema, Computerised tomogram abnormal, Haematochezia, Hypersomnia, Intussusception, Lethargy, Lymphadenopathy, Vomiting, Fontanelle depressed, Gastrointestinal sounds abnormal
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
Write-up: Information has been received from a physician concerning a male who on 11-SEP-2007 was vaccinated with a second oral dose of Rotateq. Concomitant therapy included sulfamethoxazole/trimethoprim (BACTRIM) for an ear infection. Subsequently the patient experienced intussusception. The patient was taken to the emergency room and was treated with an air enema reduction. It was reported that the patient recovered. The patient''s intussusception was considered to be immediately life-threatening by the reporter. Additional information has been requested. 10/18/2007 Vax record recieved and info updated in VAERS database. 10/30/2007 MR received for hospital DOS 9/27-30/2007 for D/C DX of Reduced Intussusception on air enema. Infant presented to the ER with intractable vomiting and dark, bloody bowel movements as well as excessive sleep. PE (+) for lack of bowel sounds, lethargy, and depressed fontenelle. (+) Currant jelly stool in ER. Barium enema successfuly reduced IS.
Vaccinated: | 2007-09-12 |
Onset: | 2007-09-27 |
Submitted: | 2007-10-15 |
Entered: | 2007-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B11UAB / 1 | LL / - |
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER | 0078U / 1 | LL / - |
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH | B265108 / 1 | RL / - |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0770U / 1 | - / PO |
Administered by: Other Purchased by: Other
Symptoms: Barium enema, Computerised tomogram abnormal, Haematochezia, Hypersomnia, Intussusception, Lethargy, Lymphadenopathy, Vomiting, Fontanelle depressed, Gastrointestinal sounds abnormal
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
Write-up: Information has been received from a physician concerning a male who on 11-SEP-2007 was vaccinated with a second oral dose of Rotateq. Concomitant therapy included sulfamethoxazole/trimethoprim (BACTRIM) for an ear infection. Subsequently the patient experienced intussusception. The patient was taken to the emergency room and was treated with an air enema reduction. It was reported that the patient recovered. The patient''s intussusception was considered to be immediately life-threatening by the reporter. Additional information has been requested. 10/18/2007 Vax record recieved and info updated in VAERS database. 10/30/2007 MR received for hospital DOS 9/27-30/2007 for D/C DX of Reduced Intussusception on air enema. Infant presented to the ER with intractable vomiting and dark, bloody bowel movements as well as excessive sleep. PE (+) for lack of bowel sounds, lethargy, and depressed fontenelle. (+) Currant jelly stool in ER. Barium enema successfuly reduced IS.
Vaccinated: | 2007-09-12 |
Onset: | 2007-09-27 |
Submitted: | 2007-10-15 |
Entered: | 2007-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B11UAB / 1 | LL / - |
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER | 0078U / 1 | LL / - |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B265108 / 1 | RL / - |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0770U / 1 | - / PO |
Administered by: Other Purchased by: Other
Symptoms: Barium enema, Computerised tomogram abnormal, Haematochezia, Hypersomnia, Intussusception, Lethargy, Lymphadenopathy, Vomiting, Fontanelle depressed, Gastrointestinal sounds abnormal
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
Write-up: Information has been received from a physician concerning a male who on 11-SEP-2007 was vaccinated with a second oral dose of Rotateq. Concomitant therapy included sulfamethoxazole/trimethoprim (BACTRIM) for an ear infection. Subsequently the patient experienced intussusception. The patient was taken to the emergency room and was treated with an air enema reduction. It was reported that the patient recovered. The patient''s intussusception was considered to be immediately life-threatening by the reporter. Additional information has been requested. 10/18/2007 Vax record recieved and info updated in VAERS database. 10/30/2007 MR received for hospital DOS 9/27-30/2007 for D/C DX of Reduced Intussusception on air enema. Infant presented to the ER with intractable vomiting and dark, bloody bowel movements as well as excessive sleep. PE (+) for lack of bowel sounds, lethargy, and depressed fontenelle. (+) Currant jelly stool in ER. Barium enema successfuly reduced IS.
Vaccinated: | 2007-09-12 |
Onset: | 2007-09-27 |
Submitted: | 2007-10-15 |
Entered: | 2007-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B11UAB / 1 | LL / - |
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER | 0078U / 1 | LL / - |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B265108 / 1 | RL / - |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0770U / 1 | - / PO |
Administered by: Other Purchased by: Other
Symptoms: Barium enema, Computerised tomogram abnormal, Haematochezia, Hypersomnia, Intussusception, Lethargy, Lymphadenopathy, Vomiting, Fontanelle depressed, Gastrointestinal sounds abnormal
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
Write-up: Information has been received from a physician concerning a male who on 11-SEP-2007 was vaccinated with a second oral dose of Rotateq. Concomitant therapy included sulfamethoxazole/trimethoprim (BACTRIM) for an ear infection. Subsequently the patient experienced intussusception. The patient was taken to the emergency room and was treated with an air enema reduction. It was reported that the patient recovered. The patient''s intussusception was considered to be immediately life-threatening by the reporter. Additional information has been requested. 10/18/2007 Vax record recieved and info updated in VAERS database. 10/30/2007 MR received for hospital DOS 9/27-30/2007 for D/C DX of Reduced Intussusception on air enema. Infant presented to the ER with intractable vomiting and dark, bloody bowel movements as well as excessive sleep. PE (+) for lack of bowel sounds, lethargy, and depressed fontenelle. (+) Currant jelly stool in ER. Barium enema successfuly reduced IS.
Vaccinated: | 2007-09-12 |
Onset: | 2007-09-27 |
Submitted: | 2007-10-15 |
Entered: | 2007-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B11UAB / 1 | LL / - |
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER | 0078U / 1 | LL / - |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B265108 / 1 | RL / - |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0770U / 1 | - / PO |
Administered by: Other Purchased by: Other
Symptoms: Barium enema, Computerised tomogram abnormal, Haematochezia, Hypersomnia, Intussusception, Lethargy, Lymphadenopathy, Vomiting, Fontanelle depressed, Gastrointestinal sounds abnormal
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
Write-up: Information has been received from a physician concerning a male who on 11-SEP-2007 was vaccinated with a second oral dose of Rotateq. Concomitant therapy included sulfamethoxazole/trimethoprim (BACTRIM) for an ear infection. Subsequently the patient experienced intussusception. The patient was taken to the emergency room and was treated with an air enema reduction. It was reported that the patient recovered. The patient''s intussusception was considered to be immediately life-threatening by the reporter. Additional information has been requested. 10/18/2007 Vax record recieved and info updated in VAERS database. 10/30/2007 MR received for hospital DOS 9/27-30/2007 for D/C DX of Reduced Intussusception on air enema. Infant presented to the ER with intractable vomiting and dark, bloody bowel movements as well as excessive sleep. PE (+) for lack of bowel sounds, lethargy, and depressed fontenelle. (+) Currant jelly stool in ER. Barium enema successfuly reduced IS.
Vaccinated: | 2007-09-12 |
Onset: | 2007-09-27 |
Submitted: | 2007-10-15 |
Entered: | 2007-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B11UAB / 1 | LL / - |
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER | 0078U / 1 | LL / - |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B265108 / 1 | RL / - |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0770U / 1 | - / PO |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0770U / 1 | - / PO |
Administered by: Other Purchased by: Other
Symptoms: Barium enema, Computerised tomogram abnormal, Haematochezia, Hypersomnia, Intussusception, Lethargy, Lymphadenopathy, Vomiting, Fontanelle depressed, Gastrointestinal sounds abnormal
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
Write-up: Information has been received from a physician concerning a male who on 11-SEP-2007 was vaccinated with a second oral dose of Rotateq. Concomitant therapy included sulfamethoxazole/trimethoprim (BACTRIM) for an ear infection. Subsequently the patient experienced intussusception. The patient was taken to the emergency room and was treated with an air enema reduction. It was reported that the patient recovered. The patient''s intussusception was considered to be immediately life-threatening by the reporter. Additional information has been requested. 10/18/2007 Vax record recieved and info updated in VAERS database. 10/30/2007 MR received for hospital DOS 9/27-30/2007 for D/C DX of Reduced Intussusception on air enema. Infant presented to the ER with intractable vomiting and dark, bloody bowel movements as well as excessive sleep. PE (+) for lack of bowel sounds, lethargy, and depressed fontenelle. (+) Currant jelly stool in ER. Barium enema successfuly reduced IS.
Vaccinated: | 2007-09-12 |
Onset: | 2007-09-27 |
Submitted: | 2007-10-15 |
Entered: | 2007-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B11UAB / 1 | LL / - |
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER | 0078U / 1 | LL / - |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B265108 / 1 | RL / - |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0770U / 1 | - / PO |
Administered by: Other Purchased by: Other
Symptoms: Barium enema, Computerised tomogram abnormal, Haematochezia, Hypersomnia, Intussusception, Lethargy, Lymphadenopathy, Vomiting, Fontanelle depressed, Gastrointestinal sounds abnormal
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
Write-up: Information has been received from a physician concerning a male who on 11-SEP-2007 was vaccinated with a second oral dose of Rotateq. Concomitant therapy included sulfamethoxazole/trimethoprim (BACTRIM) for an ear infection. Subsequently the patient experienced intussusception. The patient was taken to the emergency room and was treated with an air enema reduction. It was reported that the patient recovered. The patient''s intussusception was considered to be immediately life-threatening by the reporter. Additional information has been requested. 10/18/2007 Vax record recieved and info updated in VAERS database. 10/30/2007 MR received for hospital DOS 9/27-30/2007 for D/C DX of Reduced Intussusception on air enema. Infant presented to the ER with intractable vomiting and dark, bloody bowel movements as well as excessive sleep. PE (+) for lack of bowel sounds, lethargy, and depressed fontenelle. (+) Currant jelly stool in ER. Barium enema successfuly reduced IS.
Vaccinated: | 2007-09-12 |
Onset: | 2007-09-27 |
Submitted: | 2007-10-15 |
Entered: | 2007-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B11UAB / 1 2 | LL / - |
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER | 0078U / 1 2 | LL / - |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B265108 / 1 2 | RL / - |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0770U / 1 2 | - MO / PO |
Administered by: Other Purchased by: Other
Symptoms: Intussusception
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
Write-up: Information has been received from a physician concerning a male who on 11-SEP-2007 was vaccinated with a second oral dose of Rotateq. Concomitant therapy included sulfamethoxazole/trimethoprim (BACTRIM) for an ear infection. Subsequently the patient experienced intussusception. The patient was taken to the emergency room and was treated with an air enema reduction. It was reported that the patient recovered. The patient''s intussusception was considered to be immediately life-threatening by the reporter. Additional information has been requested. 10/18/2007 Vax record recieved and info updated in VAERS database. 10/30/2007 MR received for hospital DOS 9/27-30/2007 for D/C DX of Reduced Intussusception on air enema. Infant presented to the ER with intractable vomiting and dark, bloody bowel movements as well as excessive sleep. PE (+) for lack of bowel sounds, lethargy, and depressed fontenelle. (+) Currant jelly stool in ER. Barium enema successfuly reduced IS.
Vaccinated: | 2007-09-12 |
Onset: | 2007-09-27 |
Submitted: | 2007-10-15 |
Entered: | 2007-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B11UAB / 2 | LL / - |
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER | 0078U / 2 | LL / - |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B265108 / 2 | RL / - |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0770U / 2 | MO / PO |
Administered by: Other Purchased by: Other
Symptoms: Intussusception
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
Write-up: Information has been received from a physician concerning a male who on 11-SEP-2007 was vaccinated with a second oral dose of Rotateq. Concomitant therapy included sulfamethoxazole/trimethoprim (BACTRIM) for an ear infection. Subsequently the patient experienced intussusception. The patient was taken to the emergency room and was treated with an air enema reduction. It was reported that the patient recovered. The patient''s intussusception was considered to be immediately life-threatening by the reporter. Additional information has been requested. 10/18/2007 Vax record recieved and info updated in VAERS database. 10/30/2007 MR received for hospital DOS 9/27-30/2007 for D/C DX of Reduced Intussusception on air enema. Infant presented to the ER with intractable vomiting and dark, bloody bowel movements as well as excessive sleep. PE (+) for lack of bowel sounds, lethargy, and depressed fontenelle. (+) Currant jelly stool in ER. Barium enema successfuly reduced IS.
Vaccinated: | 2007-09-12 |
Onset: | 2007-09-27 |
Submitted: | 2007-10-15 |
Entered: | 2007-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B11UAB / 2 | LL / - |
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER | 0078U / 2 | LL / - |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B265108 / 2 | RL / - |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0770U / 2 | MO / PO |
Administered by: Other Purchased by: Other
Symptoms: Intussusception
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
Write-up: Information has been received from a physician concerning a male who on 11-SEP-2007 was vaccinated with a second oral dose of Rotateq. Concomitant therapy included sulfamethoxazole/trimethoprim (BACTRIM) for an ear infection. Subsequently the patient experienced intussusception. The patient was taken to the emergency room and was treated with an air enema reduction. It was reported that the patient recovered. The patient''s intussusception was considered to be immediately life-threatening by the reporter. Additional information has been requested. 10/18/2007 Vax record recieved and info updated in VAERS database. 10/30/2007 MR received for hospital DOS 9/27-30/2007 for D/C DX of Reduced Intussusception on air enema. Infant presented to the ER with intractable vomiting and dark, bloody bowel movements as well as excessive sleep. PE (+) for lack of bowel sounds, lethargy, and depressed fontenelle. (+) Currant jelly stool in ER. Barium enema successfuly reduced IS.
Vaccinated: | 2007-09-12 |
Onset: | 2007-09-27 |
Submitted: | 2007-10-15 |
Entered: | 2007-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B11UAB / 2 | LL / - |
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER | 0078U / 2 | LL / - |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B265108 / 2 | RL / - |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0770U / 2 | MO / PO |
Administered by: Other Purchased by: Other
Symptoms: Intussusception
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
Write-up: Information has been received from a physician concerning a male who on 11-SEP-2007 was vaccinated with a second oral dose of Rotateq. Concomitant therapy included sulfamethoxazole/trimethoprim (BACTRIM) for an ear infection. Subsequently the patient experienced intussusception. The patient was taken to the emergency room and was treated with an air enema reduction. It was reported that the patient recovered. The patient''s intussusception was considered to be immediately life-threatening by the reporter. Additional information has been requested. 10/18/2007 Vax record recieved and info updated in VAERS database. 10/30/2007 MR received for hospital DOS 9/27-30/2007 for D/C DX of Reduced Intussusception on air enema. Infant presented to the ER with intractable vomiting and dark, bloody bowel movements as well as excessive sleep. PE (+) for lack of bowel sounds, lethargy, and depressed fontenelle. (+) Currant jelly stool in ER. Barium enema successfuly reduced IS.
Vaccinated: | 2007-09-12 |
Onset: | 2007-09-27 |
Submitted: | 2007-10-15 |
Entered: | 2007-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B11UAB / 2 | LL / - |
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER | 0078U / 2 | LL / - |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B265108 / 2 | RL / - |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0770U / 2 | MO / PO |
Administered by: Other Purchased by: Other
Symptoms: Intussusception
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
Write-up: Information has been received from a physician concerning a male who on 11-SEP-2007 was vaccinated with a second oral dose of Rotateq. Concomitant therapy included sulfamethoxazole/trimethoprim (BACTRIM) for an ear infection. Subsequently the patient experienced intussusception. The patient was taken to the emergency room and was treated with an air enema reduction. It was reported that the patient recovered. The patient''s intussusception was considered to be immediately life-threatening by the reporter. Additional information has been requested. 10/18/2007 Vax record recieved and info updated in VAERS database. 10/30/2007 MR received for hospital DOS 9/27-30/2007 for D/C DX of Reduced Intussusception on air enema. Infant presented to the ER with intractable vomiting and dark, bloody bowel movements as well as excessive sleep. PE (+) for lack of bowel sounds, lethargy, and depressed fontenelle. (+) Currant jelly stool in ER. Barium enema successfuly reduced IS.
Vaccinated: | 2007-09-12 |
Onset: | 2007-09-27 |
Submitted: | 2007-10-15 |
Entered: | 2007-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B11UAB / 2 | LL / - |
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER | 0078U / 2 | LL / - |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B265108 / 2 | RL / - |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0770U / 2 | MO / PO |
Administered by: Other Purchased by: Other
Symptoms: Intussusception
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
Write-up: Information has been received from a physician concerning a male who on 11-SEP-2007 was vaccinated with a second oral dose of Rotateq. Concomitant therapy included sulfamethoxazole/trimethoprim (BACTRIM) for an ear infection. Subsequently the patient experienced intussusception. The patient was taken to the emergency room and was treated with an air enema reduction. It was reported that the patient recovered. The patient''s intussusception was considered to be immediately life-threatening by the reporter. Additional information has been requested. 10/18/2007 Vax record recieved and info updated in VAERS database. 10/30/2007 MR received for hospital DOS 9/27-30/2007 for D/C DX of Reduced Intussusception on air enema. Infant presented to the ER with intractable vomiting and dark, bloody bowel movements as well as excessive sleep. PE (+) for lack of bowel sounds, lethargy, and depressed fontenelle. (+) Currant jelly stool in ER. Barium enema successfuly reduced IS.
Link To This Search Result:
https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=293275&WAYBACKHISTORY=ON
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