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This is VAERS ID 300550

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 300550
VAERS Form:
Age:
Gender:Female
Location:North Carolina
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-12-19
Entered:2007-12-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 2 - / PO

Administered by: Other      Purchased by: Unknown
Symptoms: Barium enema, 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:     Extended hospital stay? Yes
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 a female who began the vaccination series at /"2 months of age/" (date not reported) with Rotateq. It was reported that one month after receiving the third dose of the vaccine (date not reported) s"he developed intussusception and was hospitalized. Diagnostics were not reported. The intussusception was treated with a barium enema. At the time of this report, it was reported that the patient had recovered. Intussusception was considered to be life th


Changed on 12/8/2009

VAERS ID: 300550 Before After
VAERS Form:
Age:
Gender:Female
Location:North Carolina
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-12-19
Entered:2007-12-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 2 - / PO

Administered by: Other      Purchased by: Unknown Other
Symptoms: Barium enema, 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:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0712USA03809

Write-up: Information has been received from a physician concerning a female who began the vaccination series at /"2 "2 months of age/" age" (date not reported) with Rotateq. It was reported that one month after receiving the third dose of the vaccine (date not reported) s"he she developed intussusception and was hospitalized. Diagnostics were not reported. The intussusception was treated with a barium enema. At the time of this report, it was reported that the patient had recovered. Intussusception was considered to be life th threatening and an other important medical event by the reporter. Additional information has been requested.


Changed on 5/13/2013

VAERS ID: 300550 Before After
VAERS Form:
Age:
Gender:Female
Location:North Carolina
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-12-19
Entered:2007-12-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 2 - / PO
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 2 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Barium enema, 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:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0712USA03809

Write-up: Information has been received from a physician concerning a female who began the vaccination series at "2 months of age" (date not reported) with Rotateq. It was reported that one month after receiving the third dose of the vaccine (date not reported) she developed intussusception and was hospitalized. Diagnostics were not reported. The intussusception was treated with a barium enema. At the time of this report, it was reported that the patient had recovered. Intussusception was considered to be life threatening and an other important medical event by the reporter. Additional information has been requested.


Changed on 9/14/2017

VAERS ID: 300550 Before After
VAERS Form:(blank) 1
Age:
Gender:Female
Location:North Carolina
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-12-19
Entered:2007-12-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 2 3 - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Barium enema, 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:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0712USA03809

Write-up: Information has been received from a physician concerning a female who began the vaccination series at "2 months of age" (date not reported) with Rotateq. It was reported that one month after receiving the third dose of the vaccine (date not reported) she developed intussusception and was hospitalized. Diagnostics were not reported. The intussusception was treated with a barium enema. At the time of this report, it was reported that the patient had recovered. Intussusception was considered to be life threatening and an other important medical event by the reporter. Additional information has been requested.


Changed on 2/14/2018

VAERS ID: 300550 Before After
VAERS Form:1
Age:
Gender:Female
Location:North Carolina
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-12-19
Entered:2007-12-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 3 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Barium enema, 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:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0712USA03809

Write-up: Information has been received from a physician concerning a female who began the vaccination series at "2 months of age" (date not reported) with Rotateq. It was reported that one month after receiving the third dose of the vaccine (date not reported) she developed intussusception and was hospitalized. Diagnostics were not reported. The intussusception was treated with a barium enema. At the time of this report, it was reported that the patient had recovered. Intussusception was considered to be life threatening and an other important medical event by the reporter. Additional information has been requested.


Changed on 6/14/2018

VAERS ID: 300550 Before After
VAERS Form:1
Age:
Gender:Female
Location:North Carolina
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-12-19
Entered:2007-12-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 3 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Barium enema, 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:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0712USA03809

Write-up: Information has been received from a physician concerning a female who began the vaccination series at "2 months of age" (date not reported) with Rotateq. It was reported that one month after receiving the third dose of the vaccine (date not reported) she developed intussusception and was hospitalized. Diagnostics were not reported. The intussusception was treated with a barium enema. At the time of this report, it was reported that the patient had recovered. Intussusception was considered to be life threatening and an other important medical event by the reporter. Additional information has been requested.


Changed on 8/14/2018

VAERS ID: 300550 Before After
VAERS Form:1
Age:
Gender:Female
Location:North Carolina
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-12-19
Entered:2007-12-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 3 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Barium enema, 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:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0712USA03809

Write-up: Information has been received from a physician concerning a female who began the vaccination series at "2 months of age" (date not reported) with Rotateq. It was reported that one month after receiving the third dose of the vaccine (date not reported) she developed intussusception and was hospitalized. Diagnostics were not reported. The intussusception was treated with a barium enema. At the time of this report, it was reported that the patient had recovered. Intussusception was considered to be life threatening and an other important medical event by the reporter. Additional information has been requested.


Changed on 9/14/2018

VAERS ID: 300550 Before After
VAERS Form:1
Age:
Gender:Female
Location:North Carolina
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-12-19
Entered:2007-12-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 3 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Barium enema, 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:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0712USA03809

Write-up: Information has been received from a physician concerning a female who began the vaccination series at "2 months of age" (date not reported) with Rotateq. It was reported that one month after receiving the third dose of the vaccine (date not reported) she developed intussusception and was hospitalized. Diagnostics were not reported. The intussusception was treated with a barium enema. At the time of this report, it was reported that the patient had recovered. Intussusception was considered to be life threatening and an other important medical event by the reporter. Additional information has been requested.


Changed on 10/14/2018

VAERS ID: 300550 Before After
VAERS Form:1
Age:
Gender:Female
Location:North Carolina
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-12-19
Entered:2007-12-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 3 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Barium enema, 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:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0712USA03809

Write-up: Information has been received from a physician concerning a female who began the vaccination series at "2 months of age" (date not reported) with Rotateq. It was reported that one month after receiving the third dose of the vaccine (date not reported) she developed intussusception and was hospitalized. Diagnostics were not reported. The intussusception was treated with a barium enema. At the time of this report, it was reported that the patient had recovered. Intussusception was considered to be life threatening and an other important medical event by the reporter. Additional information has been requested.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=300550&WAYBACKHISTORY=ON


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