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This is VAERS ID 294627

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 294627
VAERS Form:
Age:0.7
Gender:Unknown
Location:New Jersey
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-10-26
Entered:2007-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Inappropriate schedule of drug administration, Intussusception

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up: Information has been received from a physician concerning an 8 month old patient who was vaccinated with a complete series of Rotateq. Subsequently, a complete series of the patient experienced intussusception, sought unspecified medical attention and rec"overed. No product quality complaint was reported. No further information was available. Upon internal review intussuception was considered an other important medical event. Additional information has been requested.


Changed on 12/8/2009

VAERS ID: 294627 Before After
VAERS Form:
Age:0.7
Gender:Unknown
Location:New Jersey
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-10-26
Entered:2007-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Inappropriate schedule of drug administration, Intussusception

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0710USA03675

Write-up: Information has been received from a physician concerning an 8 month old patient who was vaccinated with a complete series of Rotateq. Subsequently, a complete series of the patient experienced intussusception, sought unspecified medical attention and rec"overed. recovered. No product quality complaint was reported. No further information was available. Upon internal review intussuception was considered an other important medical event. Additional information has been requested.


Changed on 5/13/2013

VAERS ID: 294627 Before After
VAERS Form:
Age:0.7
Gender:Unknown
Location:New Jersey
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-10-26
Entered:2007-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / - UN / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, Intussusception

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0710USA03675

Write-up: Information has been received from a physician concerning an 8 month old patient who was vaccinated with a complete series of Rotateq. Subsequently, a complete series of the patient experienced intussusception, sought unspecified medical attention and recovered. No product quality complaint was reported. No further information was available. Upon internal review intussuception was considered an other important medical event. Additional information has been requested.


Changed on 6/14/2014

VAERS ID: 294627 Before After
VAERS Form:
Age:0.7
Gender:Unknown
Location:New Jersey
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-10-26
Entered:2007-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, Intussusception

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0710USA03675

Write-up: Information has been received from a physician concerning an 8 month old patient who was vaccinated with a complete series of Rotateq. Subsequently, a complete series of the patient experienced intussusception, sought unspecified medical attention and recovered. No product quality complaint was reported. No further information was available. Upon internal review intussuception was considered an other important medical event. Additional information has been requested.


Changed on 2/14/2017

VAERS ID: 294627 Before After
VAERS Form:
Age:0.7 0.67
Gender:Unknown
Location:New Jersey
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-10-26
Entered:2007-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, Intussusception

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: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0710USA03675

Write-up: Information has been received from a physician concerning an 8 month old patient who was vaccinated with a complete series of Rotateq. Subsequently, a complete series of the patient experienced intussusception, sought unspecified medical attention and recovered. No product quality complaint was reported. No further information was available. Upon internal review intussuception was considered an other important medical event. Additional information has been requested.


Changed on 4/14/2017

VAERS ID: 294627 Before After
VAERS Form:
Age:0.67
Gender:Unknown
Location:New Jersey
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-10-26
Entered:2007-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, Intussusception

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0710USA03675

Write-up: Information has been received from a physician concerning an 8 month old patient who was vaccinated with a complete series of Rotateq. Subsequently, a complete series of the patient experienced intussusception, sought unspecified medical attention and recovered. No product quality complaint was reported. No further information was available. Upon internal review intussuception was considered an other important medical event. Additional information has been requested.


Changed on 9/14/2017

VAERS ID: 294627 Before After
VAERS Form:(blank) 1
Age:0.67
Gender:Unknown
Location:New Jersey
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-10-26
Entered:2007-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / - UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, Intussusception

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0710USA03675

Write-up: Information has been received from a physician concerning an 8 month old patient who was vaccinated with a complete series of Rotateq. Subsequently, a complete series of the patient experienced intussusception, sought unspecified medical attention and recovered. No product quality complaint was reported. No further information was available. Upon internal review intussuception was considered an other important medical event. Additional information has been requested.


Changed on 2/14/2018

VAERS ID: 294627 Before After
VAERS Form:1
Age:0.67
Gender:Unknown
Location:New Jersey
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-10-26
Entered:2007-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, Intussusception

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0710USA03675

Write-up: Information has been received from a physician concerning an 8 month old patient who was vaccinated with a complete series of Rotateq. Subsequently, a complete series of the patient experienced intussusception, sought unspecified medical attention and recovered. No product quality complaint was reported. No further information was available. Upon internal review intussuception was considered an other important medical event. Additional information has been requested.


Changed on 6/14/2018

VAERS ID: 294627 Before After
VAERS Form:1
Age:0.67
Gender:Unknown
Location:New Jersey
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-10-26
Entered:2007-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, Intussusception

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0710USA03675

Write-up: Information has been received from a physician concerning an 8 month old patient who was vaccinated with a complete series of Rotateq. Subsequently, a complete series of the patient experienced intussusception, sought unspecified medical attention and recovered. No product quality complaint was reported. No further information was available. Upon internal review intussuception was considered an other important medical event. Additional information has been requested.

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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=294627&WAYBACKHISTORY=ON


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