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This is VAERS ID 303317

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2008

VAERS ID: 303317
VAERS Form:
Age:0.4
Gender:Female
Location:Unknown
Vaccinated:2007-09-19
Onset:2008-01-09
Submitted:2008-01-15
Entered:2008-01-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0769U / 1 - / PO

Administered by: Other      Purchased by: Unknown
Symptoms: Appendicectomy, Barium enema, Blood glucose increased, Computerised tomogram abnormal, Diet refusal

Life Threatening? Yes
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: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown 3/14/08-records received-PMH: respiratory syncytial virus.
Allergies:
Diagnostic Lab Data: Unknown 3/14/08-records received-CT scan showed ileocolic intussusception and an attempt to reduce with barium enema which was unsuccessful. RSV and rotavirus negative. Labs WNL except for Glucose of 121.
CDC 'Split Type':

Write-up: Information has been received from a nurse concerning an 8 month old female who on 06-JUN-2007 was vaccinated with the first dose of Rotateq (Lot # 656393/0240U). On 19-SEP-2007, the patient was vaccinated with the second dose of Rotateq (Lot # 657522/076"9U). On 09-JAN-2008 the patient came into the office lethargic and spitting up. The patient was sent to a local hospital and was transferred to another hospital where she was admitted. The patient had surgery on 09-JAN-2008 for intussusception. As of 10-J


Changed on 12/8/2009

VAERS ID: 303317 Before After
VAERS Form:
Age:0.4
Gender:Female
Location:Unknown
Vaccinated:2007-09-19
Onset:2008-01-09
Submitted:2008-01-15
Entered:2008-01-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0769U / 1 - / PO

Administered by: Other      Purchased by: Unknown Other
Symptoms: Appendicectomy, Barium enema, Blood glucose increased, Computerised tomogram abnormal, Diet refusal, Haematochezia, Intussusception, Lethargy, Vomiting, Explorative laparotomy, Virus serology test, Rotavirus test negative

Life Threatening? Yes
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: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown 3/14/08-records received-PMH: respiratory syncytial virus.
Allergies:
Diagnostic Lab Data: Unknown 3/14/08-records received-CT scan showed ileocolic intussusception and an attempt to reduce with barium enema which was unsuccessful. RSV and rotavirus negative. Labs WNL except for Glucose of 121.
CDC 'Split Type': (blank) WAES0801USA02370

Write-up: Information has been received from a nurse concerning an 8 month old female who on 06-JUN-2007 was vaccinated with the first dose of Rotateq (Lot # 656393/0240U). On 19-SEP-2007, the patient was vaccinated with the second dose of Rotateq (Lot # 657522/076"9U). 657522/0769U). On 09-JAN-2008 the patient came into the office lethargic and spitting up. The patient was sent to a local hospital and was transferred to another hospital where she was admitted. The patient had surgery on 09-JAN-2008 for intussusception. As of 10-J 10-JAN-2008, the patient was "stabilized". The nurse felt that the intussusception was life-threatening and an other important medical event. A lot check has been requested. Additional information has been requested. 3/14/08-records received for DOS 1/9-1/11/08-DC DX: Intussusception. Hx of 1 bloody stool, vomiting and lethargy. Refused to eat. Exploratory laparotomy with reduction of intussusception and appendectomy.


Changed on 5/13/2013

VAERS ID: 303317 Before After
VAERS Form:
Age:0.4
Gender:Female
Location:Unknown
Vaccinated:2007-09-19
Onset:2008-01-09
Submitted:2008-01-15
Entered:2008-01-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0769U / 1 - / PO
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0769U / 1 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Appendicectomy, Barium enema, Blood glucose increased, Computerised tomogram abnormal, Diet refusal, Haematochezia, Intussusception, Lethargy, Vomiting, Explorative laparotomy, Virus serology test, Rotavirus test negative

Life Threatening? Yes
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: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown 3/14/08-records received-PMH: respiratory syncytial virus.
Allergies:
Diagnostic Lab Data: Unknown 3/14/08-records received-CT scan showed ileocolic intussusception and an attempt to reduce with barium enema which was unsuccessful. RSV and rotavirus negative. Labs WNL except for Glucose of 121.
CDC 'Split Type': WAES0801USA02370

Write-up: Information has been received from a nurse concerning an 8 month old female who on 06-JUN-2007 was vaccinated with the first dose of Rotateq (Lot # 656393/0240U). On 19-SEP-2007, the patient was vaccinated with the second dose of Rotateq (Lot # 657522/0769U). On 09-JAN-2008 the patient came into the office lethargic and spitting up. The patient was sent to a local hospital and was transferred to another hospital where she was admitted. The patient had surgery on 09-JAN-2008 for intussusception. As of 10-JAN-2008, the patient was "stabilized". The nurse felt that the intussusception was life-threatening and an other important medical event. A lot check has been requested. Additional information has been requested. 3/14/08-records received for DOS 1/9-1/11/08-DC DX: Intussusception. Hx of 1 bloody stool, vomiting and lethargy. Refused to eat. Exploratory laparotomy with reduction of intussusception and appendectomy.


Changed on 4/14/2017

VAERS ID: 303317 Before After
VAERS Form:
Age:0.4
Gender:Female
Location:Unknown
Vaccinated:2007-09-19
Onset:2008-01-09
Submitted:2008-01-15
Entered:2008-01-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0769U / 1 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Appendicectomy, Barium enema, Blood glucose increased, Computerised tomogram abnormal, Diet refusal, Haematochezia, Intussusception, Lethargy, Vomiting, Explorative laparotomy, Virus serology test, Rotavirus test negative

Life Threatening? Yes
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: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown 3/14/08-records received-PMH: respiratory syncytial virus.
Allergies:
Diagnostic Lab Data: Unknown 3/14/08-records received-CT scan showed ileocolic intussusception and an attempt to reduce with barium enema which was unsuccessful. RSV and rotavirus negative. Labs WNL except for Glucose of 121.
CDC 'Split Type': WAES0801USA02370

Write-up: Information has been received from a nurse concerning an 8 month old female who on 06-JUN-2007 was vaccinated with the first dose of Rotateq (Lot # 656393/0240U). On 19-SEP-2007, the patient was vaccinated with the second dose of Rotateq (Lot # 657522/0769U). On 09-JAN-2008 the patient came into the office lethargic and spitting up. The patient was sent to a local hospital and was transferred to another hospital where she was admitted. The patient had surgery on 09-JAN-2008 for intussusception. As of 10-JAN-2008, the patient was "stabilized". The nurse felt that the intussusception was life-threatening and an other important medical event. A lot check has been requested. Additional information has been requested. 3/14/08-records received for DOS 1/9-1/11/08-DC DX: Intussusception. Hx of 1 bloody stool, vomiting and lethargy. Refused to eat. Exploratory laparotomy with reduction of intussusception and appendectomy.


Changed on 9/14/2017

VAERS ID: 303317 Before After
VAERS Form:(blank) 1
Age:0.4
Gender:Female
Location:Unknown
Vaccinated:2007-09-19
Onset:2008-01-09
Submitted:2008-01-15
Entered:2008-01-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0769U / 1 2 - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Lethargy, Vomiting

Life Threatening? Yes
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: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown 3/14/08-records received-PMH: respiratory syncytial virus.
Allergies:
Diagnostic Lab Data: Unknown 3/14/08-records received-CT scan showed ileocolic intussusception and an attempt to reduce with barium enema which was unsuccessful. RSV and rotavirus negative. Labs WNL except for Glucose of 121.
CDC 'Split Type': WAES0801USA02370

Write-up: Information has been received from a nurse concerning an 8 month old female who on 06-JUN-2007 was vaccinated with the first dose of Rotateq (Lot # 656393/0240U). On 19-SEP-2007, the patient was vaccinated with the second dose of Rotateq (Lot # 657522/0769U). On 09-JAN-2008 the patient came into the office lethargic and spitting up. The patient was sent to a local hospital and was transferred to another hospital where she was admitted. The patient had surgery on 09-JAN-2008 for intussusception. As of 10-JAN-2008, the patient was "stabilized". The nurse felt that the intussusception was life-threatening and an other important medical event. A lot check has been requested. Additional information has been requested. 3/14/08-records received for DOS 1/9-1/11/08-DC DX: Intussusception. Hx of 1 bloody stool, vomiting and lethargy. Refused to eat. Exploratory laparotomy with reduction of intussusception and appendectomy.


Changed on 2/14/2018

VAERS ID: 303317 Before After
VAERS Form:1
Age:0.4
Gender:Female
Location:Unknown
Vaccinated:2007-09-19
Onset:2008-01-09
Submitted:2008-01-15
Entered:2008-01-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0769U / 2 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Lethargy, Vomiting

Life Threatening? Yes
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: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown 3/14/08-records received-PMH: respiratory syncytial virus.
Allergies:
Diagnostic Lab Data: Unknown 3/14/08-records received-CT scan showed ileocolic intussusception and an attempt to reduce with barium enema which was unsuccessful. RSV and rotavirus negative. Labs WNL except for Glucose of 121.
CDC 'Split Type': WAES0801USA02370

Write-up: Information has been received from a nurse concerning an 8 month old female who on 06-JUN-2007 was vaccinated with the first dose of Rotateq (Lot # 656393/0240U). On 19-SEP-2007, the patient was vaccinated with the second dose of Rotateq (Lot # 657522/0769U). On 09-JAN-2008 the patient came into the office lethargic and spitting up. The patient was sent to a local hospital and was transferred to another hospital where she was admitted. The patient had surgery on 09-JAN-2008 for intussusception. As of 10-JAN-2008, the patient was "stabilized". The nurse felt that the intussusception was life-threatening and an other important medical event. A lot check has been requested. Additional information has been requested. 3/14/08-records received for DOS 1/9-1/11/08-DC DX: Intussusception. Hx of 1 bloody stool, vomiting and lethargy. Refused to eat. Exploratory laparotomy with reduction of intussusception and appendectomy.


Changed on 6/14/2018

VAERS ID: 303317 Before After
VAERS Form:1
Age:0.4
Gender:Female
Location:Unknown
Vaccinated:2007-09-19
Onset:2008-01-09
Submitted:2008-01-15
Entered:2008-01-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0769U / 2 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Lethargy, Vomiting

Life Threatening? Yes
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: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown 3/14/08-records received-PMH: respiratory syncytial virus.
Allergies:
Diagnostic Lab Data: Unknown 3/14/08-records received-CT scan showed ileocolic intussusception and an attempt to reduce with barium enema which was unsuccessful. RSV and rotavirus negative. Labs WNL except for Glucose of 121.
CDC 'Split Type': WAES0801USA02370

Write-up: Information has been received from a nurse concerning an 8 month old female who on 06-JUN-2007 was vaccinated with the first dose of Rotateq (Lot # 656393/0240U). On 19-SEP-2007, the patient was vaccinated with the second dose of Rotateq (Lot # 657522/0769U). On 09-JAN-2008 the patient came into the office lethargic and spitting up. The patient was sent to a local hospital and was transferred to another hospital where she was admitted. The patient had surgery on 09-JAN-2008 for intussusception. As of 10-JAN-2008, the patient was "stabilized". The nurse felt that the intussusception was life-threatening and an other important medical event. A lot check has been requested. Additional information has been requested. 3/14/08-records received for DOS 1/9-1/11/08-DC DX: Intussusception. Hx of 1 bloody stool, vomiting and lethargy. Refused to eat. Exploratory laparotomy with reduction of intussusception and appendectomy.


Changed on 8/14/2018

VAERS ID: 303317 Before After
VAERS Form:1
Age:0.4
Gender:Female
Location:Unknown
Vaccinated:2007-09-19
Onset:2008-01-09
Submitted:2008-01-15
Entered:2008-01-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0769U / 2 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Lethargy, Vomiting

Life Threatening? Yes
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: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown 3/14/08-records received-PMH: respiratory syncytial virus.
Allergies:
Diagnostic Lab Data: Unknown 3/14/08-records received-CT scan showed ileocolic intussusception and an attempt to reduce with barium enema which was unsuccessful. RSV and rotavirus negative. Labs WNL except for Glucose of 121.
CDC 'Split Type': WAES0801USA02370

Write-up: Information has been received from a nurse concerning an 8 month old female who on 06-JUN-2007 was vaccinated with the first dose of Rotateq (Lot # 656393/0240U). On 19-SEP-2007, the patient was vaccinated with the second dose of Rotateq (Lot # 657522/0769U). On 09-JAN-2008 the patient came into the office lethargic and spitting up. The patient was sent to a local hospital and was transferred to another hospital where she was admitted. The patient had surgery on 09-JAN-2008 for intussusception. As of 10-JAN-2008, the patient was "stabilized". The nurse felt that the intussusception was life-threatening and an other important medical event. A lot check has been requested. Additional information has been requested. 3/14/08-records received for DOS 1/9-1/11/08-DC DX: Intussusception. Hx of 1 bloody stool, vomiting and lethargy. Refused to eat. Exploratory laparotomy with reduction of intussusception and appendectomy.


Changed on 9/14/2018

VAERS ID: 303317 Before After
VAERS Form:1
Age:0.4
Gender:Female
Location:Unknown
Vaccinated:2007-09-19
Onset:2008-01-09
Submitted:2008-01-15
Entered:2008-01-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0769U / 2 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Lethargy, Vomiting

Life Threatening? Yes
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: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown 3/14/08-records received-PMH: respiratory syncytial virus.
Allergies:
Diagnostic Lab Data: Unknown 3/14/08-records received-CT scan showed ileocolic intussusception and an attempt to reduce with barium enema which was unsuccessful. RSV and rotavirus negative. Labs WNL except for Glucose of 121.
CDC 'Split Type': WAES0801USA02370

Write-up: Information has been received from a nurse concerning an 8 month old female who on 06-JUN-2007 was vaccinated with the first dose of Rotateq (Lot # 656393/0240U). On 19-SEP-2007, the patient was vaccinated with the second dose of Rotateq (Lot # 657522/0769U). On 09-JAN-2008 the patient came into the office lethargic and spitting up. The patient was sent to a local hospital and was transferred to another hospital where she was admitted. The patient had surgery on 09-JAN-2008 for intussusception. As of 10-JAN-2008, the patient was "stabilized". The nurse felt that the intussusception was life-threatening and an other important medical event. A lot check has been requested. Additional information has been requested. 3/14/08-records received for DOS 1/9-1/11/08-DC DX: Intussusception. Hx of 1 bloody stool, vomiting and lethargy. Refused to eat. Exploratory laparotomy with reduction of intussusception and appendectomy.


Changed on 10/14/2018

VAERS ID: 303317 Before After
VAERS Form:1
Age:0.4
Gender:Female
Location:Unknown
Vaccinated:2007-09-19
Onset:2008-01-09
Submitted:2008-01-15
Entered:2008-01-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0769U / 2 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Lethargy, Vomiting

Life Threatening? Yes
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: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown 3/14/08-records received-PMH: respiratory syncytial virus.
Allergies:
Diagnostic Lab Data: Unknown 3/14/08-records received-CT scan showed ileocolic intussusception and an attempt to reduce with barium enema which was unsuccessful. RSV and rotavirus negative. Labs WNL except for Glucose of 121.
CDC 'Split Type': WAES0801USA02370

Write-up: Information has been received from a nurse concerning an 8 month old female who on 06-JUN-2007 was vaccinated with the first dose of Rotateq (Lot # 656393/0240U). On 19-SEP-2007, the patient was vaccinated with the second dose of Rotateq (Lot # 657522/0769U). On 09-JAN-2008 the patient came into the office lethargic and spitting up. The patient was sent to a local hospital and was transferred to another hospital where she was admitted. The patient had surgery on 09-JAN-2008 for intussusception. As of 10-JAN-2008, the patient was "stabilized". The nurse felt that the intussusception was life-threatening and an other important medical event. A lot check has been requested. Additional information has been requested. 3/14/08-records received for DOS 1/9-1/11/08-DC DX: Intussusception. Hx of 1 bloody stool, vomiting and lethargy. Refused to eat. Exploratory laparotomy with reduction of intussusception and appendectomy.

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