National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 293837

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 293837
VAERS Form:
Age:0.2
Gender:Female
Location:Michigan
Vaccinated:2007-05-25
Onset:2007-07-28
Submitted:2007-10-19
Entered:2007-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0214U / - - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Barium enema, Crying, Full blood count, Abdominal X-ray

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Labs and Diagnostics: Abd X-ray suspicious for Intussusception in the RLQ. Barium Enema with reduction of IS. CBC with WBC 18.1.
CDC 'Split Type':

Write-up: After first dose of Rotateq developed intussusception approx. 5 weeks later. After second dose of Rotateq developed intussusception one week later. Both episdoses treated at Hospital.


Changed on 12/8/2009

VAERS ID: 293837 Before After
VAERS Form:
Age:0.2
Gender:Female
Location:Michigan
Vaccinated:2007-05-25
Onset:2007-07-28
Submitted:2007-10-19
Entered:2007-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0214U / - - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Barium enema, Crying, Full blood count, Haematochezia, Intussusception, Vomiting, White blood cell count increased, Abdominal X-ray, Occult blood positive, Similar reaction on previous exposure to drug, Oral intake reduced

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Labs and Diagnostics: Abd X-ray suspicious for Intussusception in the RLQ. Barium Enema with reduction of IS. CBC with WBC 18.1. Labs and Diagnostics 9/8/07: CBC WNL. Abd X-ray (+) filling defect near hepatic flexure, probable Intussusc
CDC 'Split Type':

Write-up: After first dose of Rotateq developed intussusception approx. 5 weeks later. After second dose of Rotateq developed intussusception one week later. Both episdoses treated at Hospital. 10/29/2007 MR received for hospital DOS 7/28-29/2007 fo Dx: Intussusception. Infant initially presented with inconsolable crying and blood in stool. Vomiting developed which was green initially then orange. Rectal exam at another facility (+) for rectal bleeding and pt transfered to current facility. In ER had Currant Jelly stool, Guiac (+). Decreased po intake. Infant had a successful reduction of Intussusception via Barium enema. 10/31/2007 Vax record received and submitted for scanning. Lot number same as VAERS report. 01/25/2008 MR received for ER visit 9/08/2007 with DX: Intussusception-reduced spontaneously. Child presented to ER with blood in stool which "looked like jelly", vomiting and abdominal pain. Rust colored sputum noted in tracea on PE.


Changed on 5/13/2013

VAERS ID: 293837 Before After
VAERS Form:
Age:0.2
Gender:Female
Location:Michigan
Vaccinated:2007-05-25
Onset:2007-07-28
Submitted:2007-10-19
Entered:2007-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0214U / - - / PO
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0214U / - - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Barium enema, Crying, Full blood count, Haematochezia, Intussusception, Vomiting, White blood cell count increased, Abdominal X-ray, Occult blood positive, Similar reaction on previous exposure to drug, Oral intake reduced

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Labs and Diagnostics: Abd X-ray suspicious for Intussusception in the RLQ. Barium Enema with reduction of IS. CBC with WBC 18.1. Labs and Diagnostics 9/8/07: CBC WNL. Abd X-ray (+) filling defect near hepatic flexure, probable Intussusc
CDC 'Split Type':

Write-up: After first dose of Rotateq developed intussusception approx. 5 weeks later. After second dose of Rotateq developed intussusception one week later. Both episdoses treated at Hospital. 10/29/2007 MR received for hospital DOS 7/28-29/2007 fo Dx: Intussusception. Infant initially presented with inconsolable crying and blood in stool. Vomiting developed which was green initially then orange. Rectal exam at another facility (+) for rectal bleeding and pt transfered to current facility. In ER had Currant Jelly stool, Guiac (+). Decreased po intake. Infant had a successful reduction of Intussusception via Barium enema. 10/31/2007 Vax record received and submitted for scanning. Lot number same as VAERS report. 01/25/2008 MR received for ER visit 9/08/2007 with DX: Intussusception-reduced spontaneously. Child presented to ER with blood in stool which "looked like jelly", vomiting and abdominal pain. Rust colored sputum noted in tracea on PE.


Changed on 2/14/2017

VAERS ID: 293837 Before After
VAERS Form:
Age:0.2
Gender:Female
Location:Michigan
Vaccinated:2007-05-25
Onset:2007-07-28
Submitted:2007-10-19
Entered:2007-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0214U / - - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Barium enema, Crying, Full blood count, Haematochezia, Intussusception, Vomiting, White blood cell count increased, Abdominal X-ray, Occult blood positive, Similar reaction on previous exposure to drug, Oral intake reduced

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Labs and Diagnostics: Abd X-ray suspicious for Intussusception in the RLQ. Barium Enema with reduction of IS. CBC with WBC 18.1. Labs and Diagnostics 9/8/07: CBC WNL. Abd X-ray (+) filling defect near hepatic flexure, probable Intussusc Intussusception. Barium enema with reflux of contrast into small bowel and reduction of what is believed to be an ileocolonic type intussusception./
CDC 'Split Type':

Write-up: After first dose of Rotateq developed intussusception approx. 5 weeks later. After second dose of Rotateq developed intussusception one week later. Both episdoses treated at Hospital. 10/29/2007 MR received for hospital DOS 7/28-29/2007 fo Dx: Intussusception. Infant initially presented with inconsolable crying and blood in stool. Vomiting developed which was green initially then orange. Rectal exam at another facility (+) for rectal bleeding and pt transfered to current facility. In ER had Currant Jelly stool, Guiac (+). Decreased po intake. Infant had a successful reduction of Intussusception via Barium enema. 10/31/2007 Vax record received and submitted for scanning. Lot number same as VAERS report. 01/25/2008 MR received for ER visit 9/08/2007 with DX: Intussusception-reduced spontaneously. Child presented to ER with blood in stool which "looked like jelly", vomiting and abdominal pain. Rust colored sputum noted in tracea on PE.


Changed on 9/14/2017

VAERS ID: 293837 Before After
VAERS Form:(blank) 1
Age:0.2
Gender:Female
Location:Michigan
Vaccinated:2007-05-25
Onset:2007-07-28
Submitted:2007-10-19
Entered:2007-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0214U / - UNK - MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intussusception, Similar reaction on previous exposure to drug

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Labs and Diagnostics: Abd X-ray suspicious for Intussusception in the RLQ. Barium Enema with reduction of IS. CBC with WBC 18.1. Labs and Diagnostics 9/8/07: CBC WNL. Abd X-ray (+) filling defect near hepatic flexure, probable Intussusception. Barium enema with reflux of contrast into small bowel and reduction of what is believed to be an ileocolonic type intussusception./
CDC 'Split Type':

Write-up: After first dose of Rotateq developed intussusception approx. 5 weeks later. After second dose of Rotateq developed intussusception one week later. Both episdoses treated at Hospital. 10/29/2007 MR received for hospital DOS 7/28-29/2007 fo Dx: Intussusception. Infant initially presented with inconsolable crying and blood in stool. Vomiting developed which was green initially then orange. Rectal exam at another facility (+) for rectal bleeding and pt transfered to current facility. In ER had Currant Jelly stool, Guiac (+). Decreased po intake. Infant had a successful reduction of Intussusception via Barium enema. 10/31/2007 Vax record received and submitted for scanning. Lot number same as VAERS report. 01/25/2008 MR received for ER visit 9/08/2007 with DX: Intussusception-reduced spontaneously. Child presented to ER with blood in stool which "looked like jelly", vomiting and abdominal pain. Rust colored sputum noted in tracea on PE.


Changed on 2/14/2018

VAERS ID: 293837 Before After
VAERS Form:1
Age:0.2
Gender:Female
Location:Michigan
Vaccinated:2007-05-25
Onset:2007-07-28
Submitted:2007-10-19
Entered:2007-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0214U / UNK MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intussusception, Similar reaction on previous exposure to drug

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Labs and Diagnostics: Abd X-ray suspicious for Intussusception in the RLQ. Barium Enema with reduction of IS. CBC with WBC 18.1. Labs and Diagnostics 9/8/07: CBC WNL. Abd X-ray (+) filling defect near hepatic flexure, probable Intussusception. Barium enema with reflux of contrast into small bowel and reduction of what is believed to be an ileocolonic type intussusception./
CDC 'Split Type':

Write-up: After first dose of Rotateq developed intussusception approx. 5 weeks later. After second dose of Rotateq developed intussusception one week later. Both episdoses treated at Hospital. 10/29/2007 MR received for hospital DOS 7/28-29/2007 fo Dx: Intussusception. Infant initially presented with inconsolable crying and blood in stool. Vomiting developed which was green initially then orange. Rectal exam at another facility (+) for rectal bleeding and pt transfered to current facility. In ER had Currant Jelly stool, Guiac (+). Decreased po intake. Infant had a successful reduction of Intussusception via Barium enema. 10/31/2007 Vax record received and submitted for scanning. Lot number same as VAERS report. 01/25/2008 MR received for ER visit 9/08/2007 with DX: Intussusception-reduced spontaneously. Child presented to ER with blood in stool which "looked like jelly", vomiting and abdominal pain. Rust colored sputum noted in tracea on PE.


Changed on 6/14/2018

VAERS ID: 293837 Before After
VAERS Form:1
Age:0.2
Gender:Female
Location:Michigan
Vaccinated:2007-05-25
Onset:2007-07-28
Submitted:2007-10-19
Entered:2007-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0214U / UNK MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intussusception, Similar reaction on previous exposure to drug

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Labs and Diagnostics: Abd X-ray suspicious for Intussusception in the RLQ. Barium Enema with reduction of IS. CBC with WBC 18.1. Labs and Diagnostics 9/8/07: CBC WNL. Abd X-ray (+) filling defect near hepatic flexure, probable Intussusception. Barium enema with reflux of contrast into small bowel and reduction of what is believed to be an ileocolonic type intussusception./
CDC 'Split Type':

Write-up: After first dose of Rotateq developed intussusception approx. 5 weeks later. After second dose of Rotateq developed intussusception one week later. Both episdoses treated at Hospital. 10/29/2007 MR received for hospital DOS 7/28-29/2007 fo Dx: Intussusception. Infant initially presented with inconsolable crying and blood in stool. Vomiting developed which was green initially then orange. Rectal exam at another facility (+) for rectal bleeding and pt transfered to current facility. In ER had Currant Jelly stool, Guiac (+). Decreased po intake. Infant had a successful reduction of Intussusception via Barium enema. 10/31/2007 Vax record received and submitted for scanning. Lot number same as VAERS report. 01/25/2008 MR received for ER visit 9/08/2007 with DX: Intussusception-reduced spontaneously. Child presented to ER with blood in stool which "looked like jelly", vomiting and abdominal pain. Rust colored sputum noted in tracea on PE.


Changed on 8/14/2018

VAERS ID: 293837 Before After
VAERS Form:1
Age:0.2
Gender:Female
Location:Michigan
Vaccinated:2007-05-25
Onset:2007-07-28
Submitted:2007-10-19
Entered:2007-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0214U / UNK MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intussusception, Similar reaction on previous exposure to drug

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Labs and Diagnostics: Abd X-ray suspicious for Intussusception in the RLQ. Barium Enema with reduction of IS. CBC with WBC 18.1. Labs and Diagnostics 9/8/07: CBC WNL. Abd X-ray (+) filling defect near hepatic flexure, probable Intussusception. Barium enema with reflux of contrast into small bowel and reduction of what is believed to be an ileocolonic type intussusception./
CDC 'Split Type':

Write-up: After first dose of Rotateq developed intussusception approx. 5 weeks later. After second dose of Rotateq developed intussusception one week later. Both episdoses treated at Hospital. 10/29/2007 MR received for hospital DOS 7/28-29/2007 fo Dx: Intussusception. Infant initially presented with inconsolable crying and blood in stool. Vomiting developed which was green initially then orange. Rectal exam at another facility (+) for rectal bleeding and pt transfered to current facility. In ER had Currant Jelly stool, Guiac (+). Decreased po intake. Infant had a successful reduction of Intussusception via Barium enema. 10/31/2007 Vax record received and submitted for scanning. Lot number same as VAERS report. 01/25/2008 MR received for ER visit 9/08/2007 with DX: Intussusception-reduced spontaneously. Child presented to ER with blood in stool which "looked like jelly", vomiting and abdominal pain. Rust colored sputum noted in tracea on PE.


Changed on 9/14/2018

VAERS ID: 293837 Before After
VAERS Form:1
Age:0.2
Gender:Female
Location:Michigan
Vaccinated:2007-05-25
Onset:2007-07-28
Submitted:2007-10-19
Entered:2007-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0214U / UNK MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intussusception, Similar reaction on previous exposure to drug

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Labs and Diagnostics: Abd X-ray suspicious for Intussusception in the RLQ. Barium Enema with reduction of IS. CBC with WBC 18.1. Labs and Diagnostics 9/8/07: CBC WNL. Abd X-ray (+) filling defect near hepatic flexure, probable Intussusception. Barium enema with reflux of contrast into small bowel and reduction of what is believed to be an ileocolonic type intussusception./
CDC 'Split Type':

Write-up: After first dose of Rotateq developed intussusception approx. 5 weeks later. After second dose of Rotateq developed intussusception one week later. Both episdoses treated at Hospital. 10/29/2007 MR received for hospital DOS 7/28-29/2007 fo Dx: Intussusception. Infant initially presented with inconsolable crying and blood in stool. Vomiting developed which was green initially then orange. Rectal exam at another facility (+) for rectal bleeding and pt transfered to current facility. In ER had Currant Jelly stool, Guiac (+). Decreased po intake. Infant had a successful reduction of Intussusception via Barium enema. 10/31/2007 Vax record received and submitted for scanning. Lot number same as VAERS report. 01/25/2008 MR received for ER visit 9/08/2007 with DX: Intussusception-reduced spontaneously. Child presented to ER with blood in stool which "looked like jelly", vomiting and abdominal pain. Rust colored sputum noted in tracea on PE.

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=293837&WAYBACKHISTORY=ON


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