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This is VAERS ID 309001

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2008

VAERS ID: 309001
VAERS Form:
Age:0.4
Sex:Female
Location:Pennsylvania
Vaccinated:2007-08-08
Onset:2007-09-21
Submitted:2008-04-04
Entered:2008-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0240U / 1 - / PO

Administered by: Other      Purchased by: Unknown
Symptoms: Barium enema abnormal, Crying, Diarrhoea, Intussusception

Life Threatening? No
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
Allergies:
Diagnostic Lab Data: barium enema X-ray 09/21/07 - intussusception resolved 8/4/08-records received- US confirmed intussusception in right upper quadrant. Therapeutic contrast enema, successful reduction of ileocolic intussusception.
CDC 'Split Type':

Write-up: Information has been received from a physician concerning a 26 week old female who on 25-MAY-2007 and 08-AUG-2007 was vaccinated PO with her first and second 2.0 ml doses of Rotateq (lot# /"12337,/" 656393/0240U). On 21-SEP-2007 the patient was seen in t"he physician''''s office since the patient experienced vomiting, crying and loose stools. The patient did not have bloody stools. The patient was admitted to a children''''s hospital that same day and was diagnosed with intussusception. The patient was hos


Changed on 12/8/2009

VAERS ID: 309001 Before After
VAERS Form:
Age:0.4
Sex:Female
Location:Pennsylvania
Vaccinated:2007-08-08
Onset:2007-09-21
Submitted:2008-04-04
Entered:2008-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0240U / 1 - / PO

Administered by: Other      Purchased by: Unknown Other
Symptoms: Barium enema abnormal, Crying, Diarrhoea, Intussusception, Irritability, Vomiting, Ultrasound abdomen abnormal

Life Threatening? No
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
Allergies:
Diagnostic Lab Data: barium enema X-ray 09/21/07 - intussusception resolved 8/4/08-records received- US confirmed intussusception in right upper quadrant. Therapeutic contrast enema, successful reduction of ileocolic intussusception.
CDC 'Split Type': (blank) WAES0803USA04735

Write-up: Information has been received from a physician concerning a 26 week old female who on 25-MAY-2007 and 08-AUG-2007 was vaccinated PO with her first and second 2.0 ml doses of Rotateq (lot# /"12337,/" "12337," 656393/0240U). On 21-SEP-2007 the patient was seen in t"he physician''''s the physician''s office since the patient experienced vomiting, crying and loose stools. The patient did not have bloody stools. The patient was admitted to a children''''s children''s hospital that same day and was diagnosed with intussusception. The patient was hos hospitalized for 3 days. A barium enema resolved the intussusception. The patient was discharged from the hospital on 23-SEP-2007. On 24-SEP-2007 the patient was seen in the physician''s office and the physician stated the patient had been vomiting, but with no dehydration. The patient had a bowel movement with no blood in the stools. Therapy with Rotateq was discontinued on 08-AUG-2007. The physician stated the patient was recovering. There was no product quality complaint. Additional information has been requested.8/4/08-records received for DOS 9/21-9/23/07-DC DX: Intussusception. Presented to ED with C/O vomiting and loose bowel movement times 1-2 days. Crying, irritable.


Changed on 1/7/2013

VAERS ID: 309001 Before After
VAERS Form:
Age:0.4
Sex:Female
Location:Pennsylvania
Vaccinated:2007-08-08
Onset:2007-09-21
Submitted:2008-04-04
Entered:2008-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0240U / 1 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Barium enema abnormal, Crying, Diarrhoea, Intussusception, Irritability, Vomiting, Ultrasound abdomen abnormal

Life Threatening? No
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
Allergies:
Diagnostic Lab Data: barium enema X-ray 09/21/07 - intussusception resolved 8/4/08-records received- US confirmed intussusception in right upper quadrant. Therapeutic contrast enema, successful reduction of ileocolic intussusception.
CDC 'Split Type': WAES0803USA04735

Write-up: Information has been received from a physician concerning a 26 week old female who on 25-MAY-2007 and 08-AUG-2007 was vaccinated PO with her first and second 2.0 ml doses of Rotateq (lot# "12337," 656393/0240U). On 21-SEP-2007 the patient was seen in the physician''s office since the patient experienced vomiting, crying and loose stools. The patient did not have bloody stools. The patient was admitted to a children''s hospital that same day and was diagnosed with intussusception. The patient was hospitalized for 3 days. A barium enema resolved the intussusception. The patient was discharged from the hospital on 23-SEP-2007. On 24-SEP-2007 the patient was seen in the physician''s office and the physician stated the patient had been vomiting, but with no dehydration. The patient had a bowel movement with no blood in the stools. Therapy with Rotateq was discontinued on 08-AUG-2007. The physician stated the patient was recovering. There was no product quality complaint. Additional information has been requested.8/4/08-records received for DOS 9/21-9/23/07-DC DX: Intussusception. Presented to ED with C/O vomiting and loose bowel movement times 1-2 days. Crying, irritable.


Changed on 5/13/2013

VAERS ID: 309001 Before After
VAERS Form:
Age:0.4
Sex:Female
Location:Pennsylvania
Vaccinated:2007-08-08
Onset:2007-09-21
Submitted:2008-04-04
Entered:2008-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0240U / 1 - / PO
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0240U / 1 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Barium enema abnormal, Crying, Diarrhoea, Intussusception, Irritability, Vomiting, Ultrasound abdomen abnormal

Life Threatening? No
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
Allergies:
Diagnostic Lab Data: barium enema X-ray 09/21/07 - intussusception resolved 8/4/08-records received- US confirmed intussusception in right upper quadrant. Therapeutic contrast enema, successful reduction of ileocolic intussusception.
CDC 'Split Type': WAES0803USA04735

Write-up: Information has been received from a physician concerning a 26 week old female who on 25-MAY-2007 and 08-AUG-2007 was vaccinated PO with her first and second 2.0 ml doses of Rotateq (lot# "12337," 656393/0240U). On 21-SEP-2007 the patient was seen in the physician''s office since the patient experienced vomiting, crying and loose stools. The patient did not have bloody stools. The patient was admitted to a hospital that same day and was diagnosed with intussusception. The patient was hospitalized for 3 days. A barium enema resolved the intussusception. The patient was discharged from the hospital on 23-SEP-2007. On 24-SEP-2007 the patient was seen in the physician''s office and the physician stated the patient had been vomiting, but with no dehydration. The patient had a bowel movement with no blood in the stools. Therapy with Rotateq was discontinued on 08-AUG-2007. The physician stated the patient was recovering. There was no product quality complaint. Additional information has been requested.8/4/08-records received for DOS 9/21-9/23/07-DC DX: Intussusception. Presented to ED with C/O vomiting and loose bowel movement times 1-2 days. Crying, irritable.


Changed on 6/14/2014

VAERS ID: 309001 Before After
VAERS Form:
Age:0.4
Sex:Female
Location:Pennsylvania
Vaccinated:2007-08-08
Onset:2007-09-21
Submitted:2008-04-04
Entered:2008-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0240U / 1 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Barium enema abnormal, Crying, Diarrhoea, Intussusception, Irritability, Vomiting, Ultrasound abdomen abnormal

Life Threatening? No
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
Allergies:
Diagnostic Lab Data: barium enema X-ray 09/21/07 - intussusception resolved 8/4/08-records received- US confirmed intussusception in right upper quadrant. Therapeutic contrast enema, successful reduction of ileocolic intussusception.
CDC 'Split Type': WAES0803USA04735

Write-up: Information has been received from a physician concerning a 26 week old female who on 25-MAY-2007 and 08-AUG-2007 was vaccinated PO with her first and second 2.0 ml doses of Rotateq (lot# "12337," 656393/0240U). On 21-SEP-2007 the patient was seen in the physician''s office since the patient experienced vomiting, crying and loose stools. The patient did not have bloody stools. The patient was admitted to a hospital that same day and was diagnosed with intussusception. The patient was hospitalized for 3 days. A barium enema resolved the intussusception. The patient was discharged from the hospital on 23-SEP-2007. On 24-SEP-2007 the patient was seen in the physician''s office and the physician stated the patient had been vomiting, but with no dehydration. The patient had a bowel movement with no blood in the stools. Therapy with Rotateq was discontinued on 08-AUG-2007. The physician stated the patient was recovering. There was no product quality complaint. Additional information has been requested.8/4/08-records received for DOS 9/21-9/23/07-DC DX: Intussusception. Presented to ED with C/O vomiting and loose bowel movement times 1-2 days. Crying, irritable.


Changed on 3/14/2015

VAERS ID: 309001 Before After
VAERS Form:
Age:0.4
Sex:Female
Location:Pennsylvania
Vaccinated:2007-08-08
Onset:2007-09-21
Submitted:2008-04-04
Entered:2008-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0240U / 1 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Barium enema abnormal, Crying, Diarrhoea, Intussusception, Irritability, Vomiting, Ultrasound abdomen abnormal

Life Threatening? No
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
Allergies:
Diagnostic Lab Data: barium enema X-ray 09/21/07 - intussusception resolved 8/4/08-records received- US confirmed intussusception in right upper quadrant. Therapeutic contrast enema, successful reduction of ileocolic intussusception.
CDC 'Split Type': WAES0803USA04735

Write-up: Information has been received from a physician concerning a 26 week old female who on 25-MAY-2007 and 08-AUG-2007 was vaccinated PO with her first and second 2.0 ml doses of Rotateq (lot# "12337," 656393/0240U). On 21-SEP-2007 the patient was seen in the physician''s office since the patient experienced vomiting, crying and loose stools. The patient did not have bloody stools. The patient was admitted to a hospital that same day and was diagnosed with intussusception. The patient was hospitalized for 3 days. A barium enema resolved the intussusception. The patient was discharged from the hospital on 23-SEP-2007. On 24-SEP-2007 the patient was seen in the physician''s office and the physician stated the patient had been vomiting, but with no dehydration. The patient had a bowel movement with no blood in the stools. Therapy with Rotateq was discontinued on 08-AUG-2007. The physician stated the patient was recovering. There was no product quality complaint. Additional information has been requested.8/4/08-records received for DOS 9/21-9/23/07-DC DX: Intussusception. Presented to ED with C/O vomiting and loose bowel movement times 1-2 days. Crying, irritable.


Changed on 2/14/2017

VAERS ID: 309001 Before After
VAERS Form:
Age:0.4 0.38
Sex:Female
Location:Pennsylvania
Vaccinated:2007-08-08
Onset:2007-09-21
Submitted:2008-04-04
Entered:2008-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0240U / 1 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Barium enema abnormal, Crying, Diarrhoea, Intussusception, Irritability, Vomiting, Ultrasound abdomen abnormal

Life Threatening? No
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
Allergies:
Diagnostic Lab Data: barium enema X-ray 09/21/07 - intussusception resolved 8/4/08-records received- US confirmed intussusception in right upper quadrant. Therapeutic contrast enema, successful reduction of ileocolic intussusception.
CDC 'Split Type': WAES0803USA04735

Write-up: Information has been received from a physician concerning a 26 week old female who on 25-MAY-2007 and 08-AUG-2007 was vaccinated PO with her first and second 2.0 ml doses of Rotateq (lot# "12337," 656393/0240U). On 21-SEP-2007 the patient was seen in the physician''s office since the patient experienced vomiting, crying and loose stools. The patient did not have bloody stools. The patient was admitted to a hospital that same day and was diagnosed with intussusception. The patient was hospitalized for 3 days. A barium enema resolved the intussusception. The patient was discharged from the hospital on 23-SEP-2007. On 24-SEP-2007 the patient was seen in the physician''s office and the physician stated the patient had been vomiting, but with no dehydration. The patient had a bowel movement with no blood in the stools. Therapy with Rotateq was discontinued on 08-AUG-2007. The physician stated the patient was recovering. There was no product quality complaint. Additional information has been requested.8/4/08-records received for DOS 9/21-9/23/07-DC DX: Intussusception. Presented to ED with C/O vomiting and loose bowel movement times 1-2 days. Crying, irritable.


Changed on 4/14/2017

VAERS ID: 309001 Before After
VAERS Form:
Age:0.38
Sex:Female
Location:Pennsylvania
Vaccinated:2007-08-08
Onset:2007-09-21
Submitted:2008-04-04
Entered:2008-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0240U / 1 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Barium enema abnormal, Crying, Diarrhoea, Intussusception, Irritability, Vomiting, Ultrasound abdomen abnormal

Life Threatening? No
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
Allergies:
Diagnostic Lab Data: barium enema X-ray 09/21/07 - intussusception resolved 8/4/08-records received- US confirmed intussusception in right upper quadrant. Therapeutic contrast enema, successful reduction of ileocolic intussusception.
CDC 'Split Type': WAES0803USA04735

Write-up: Information has been received from a physician concerning a 26 week old female who on 25-MAY-2007 and 08-AUG-2007 was vaccinated PO with her first and second 2.0 ml doses of Rotateq (lot# "12337," 656393/0240U). On 21-SEP-2007 the patient was seen in the physician''s office since the patient experienced vomiting, crying and loose stools. The patient did not have bloody stools. The patient was admitted to a hospital that same day and was diagnosed with intussusception. The patient was hospitalized for 3 days. A barium enema resolved the intussusception. The patient was discharged from the hospital on 23-SEP-2007. On 24-SEP-2007 the patient was seen in the physician''s office and the physician stated the patient had been vomiting, but with no dehydration. The patient had a bowel movement with no blood in the stools. Therapy with Rotateq was discontinued on 08-AUG-2007. The physician stated the patient was recovering. There was no product quality complaint. Additional information has been requested.8/4/08-records received for DOS 9/21-9/23/07-DC DX: Intussusception. Presented to ED with C/O vomiting and loose bowel movement times 1-2 days. Crying, irritable.


Changed on 9/14/2017

VAERS ID: 309001 Before After
VAERS Form:(blank) 1
Age:0.38
Sex:Female
Location:Pennsylvania
Vaccinated:2007-08-08
Onset:2007-09-21
Submitted:2008-04-04
Entered:2008-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0240U / 1 2 - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Crying, Diarrhoea, Intussusception, Vomiting

Life Threatening? No
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
Allergies:
Diagnostic Lab Data: barium enema X-ray 09/21/07 - intussusception resolved 8/4/08-records received- US confirmed intussusception in right upper quadrant. Therapeutic contrast enema, successful reduction of ileocolic intussusception.
CDC 'Split Type': WAES0803USA04735

Write-up: Information has been received from a physician concerning a 26 week old female who on 25-MAY-2007 and 08-AUG-2007 was vaccinated PO with her first and second 2.0 ml doses of Rotateq (lot# "12337," 656393/0240U). On 21-SEP-2007 the patient was seen in the physician''s office since the patient experienced vomiting, crying and loose stools. The patient did not have bloody stools. The patient was admitted to a hospital that same day and was diagnosed with intussusception. The patient was hospitalized for 3 days. A barium enema resolved the intussusception. The patient was discharged from the hospital on 23-SEP-2007. On 24-SEP-2007 the patient was seen in the physician''s office and the physician stated the patient had been vomiting, but with no dehydration. The patient had a bowel movement with no blood in the stools. Therapy with Rotateq was discontinued on 08-AUG-2007. The physician stated the patient was recovering. There was no product quality complaint. Additional information has been requested.8/4/08-records received for DOS 9/21-9/23/07-DC DX: Intussusception. Presented to ED with C/O vomiting and loose bowel movement times 1-2 days. Crying, irritable.


Changed on 2/14/2018

VAERS ID: 309001 Before After
VAERS Form:1
Age:0.38
Sex:Female
Location:Pennsylvania
Vaccinated:2007-08-08
Onset:2007-09-21
Submitted:2008-04-04
Entered:2008-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0240U / 2 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Crying, Diarrhoea, Intussusception, Vomiting

Life Threatening? No
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
Allergies:
Diagnostic Lab Data: barium enema X-ray 09/21/07 - intussusception resolved 8/4/08-records received- US confirmed intussusception in right upper quadrant. Therapeutic contrast enema, successful reduction of ileocolic intussusception.
CDC 'Split Type': WAES0803USA04735

Write-up: Information has been received from a physician concerning a 26 week old female who on 25-MAY-2007 and 08-AUG-2007 was vaccinated PO with her first and second 2.0 ml doses of Rotateq (lot# "12337," 656393/0240U). On 21-SEP-2007 the patient was seen in the physician''s office since the patient experienced vomiting, crying and loose stools. The patient did not have bloody stools. The patient was admitted to a hospital that same day and was diagnosed with intussusception. The patient was hospitalized for 3 days. A barium enema resolved the intussusception. The patient was discharged from the hospital on 23-SEP-2007. On 24-SEP-2007 the patient was seen in the physician''s office and the physician stated the patient had been vomiting, but with no dehydration. The patient had a bowel movement with no blood in the stools. Therapy with Rotateq was discontinued on 08-AUG-2007. The physician stated the patient was recovering. There was no product quality complaint. Additional information has been requested.8/4/08-records received for DOS 9/21-9/23/07-DC DX: Intussusception. Presented to ED with C/O vomiting and loose bowel movement times 1-2 days. Crying, irritable.


Changed on 6/14/2018

VAERS ID: 309001 Before After
VAERS Form:1
Age:0.38
Sex:Female
Location:Pennsylvania
Vaccinated:2007-08-08
Onset:2007-09-21
Submitted:2008-04-04
Entered:2008-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0240U / 2 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Crying, Diarrhoea, Intussusception, Vomiting

Life Threatening? No
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
Allergies:
Diagnostic Lab Data: barium enema X-ray 09/21/07 - intussusception resolved 8/4/08-records received- US confirmed intussusception in right upper quadrant. Therapeutic contrast enema, successful reduction of ileocolic intussusception.
CDC 'Split Type': WAES0803USA04735

Write-up: Information has been received from a physician concerning a 26 week old female who on 25-MAY-2007 and 08-AUG-2007 was vaccinated PO with her first and second 2.0 ml doses of Rotateq (lot# "12337," 656393/0240U). On 21-SEP-2007 the patient was seen in the physician''s office since the patient experienced vomiting, crying and loose stools. The patient did not have bloody stools. The patient was admitted to a hospital that same day and was diagnosed with intussusception. The patient was hospitalized for 3 days. A barium enema resolved the intussusception. The patient was discharged from the hospital on 23-SEP-2007. On 24-SEP-2007 the patient was seen in the physician''s office and the physician stated the patient had been vomiting, but with no dehydration. The patient had a bowel movement with no blood in the stools. Therapy with Rotateq was discontinued on 08-AUG-2007. The physician stated the patient was recovering. There was no product quality complaint. Additional information has been requested.8/4/08-records received for DOS 9/21-9/23/07-DC DX: Intussusception. Presented to ED with C/O vomiting and loose bowel movement times 1-2 days. Crying, irritable.


Changed on 8/14/2018

VAERS ID: 309001 Before After
VAERS Form:1
Age:0.38
Sex:Female
Location:Pennsylvania
Vaccinated:2007-08-08
Onset:2007-09-21
Submitted:2008-04-04
Entered:2008-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0240U / 2 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Crying, Diarrhoea, Intussusception, Vomiting

Life Threatening? No
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
Allergies:
Diagnostic Lab Data: barium enema X-ray 09/21/07 - intussusception resolved 8/4/08-records received- US confirmed intussusception in right upper quadrant. Therapeutic contrast enema, successful reduction of ileocolic intussusception.
CDC 'Split Type': WAES0803USA04735

Write-up: Information has been received from a physician concerning a 26 week old female who on 25-MAY-2007 and 08-AUG-2007 was vaccinated PO with her first and second 2.0 ml doses of Rotateq (lot# "12337," 656393/0240U). On 21-SEP-2007 the patient was seen in the physician''s office since the patient experienced vomiting, crying and loose stools. The patient did not have bloody stools. The patient was admitted to a hospital that same day and was diagnosed with intussusception. The patient was hospitalized for 3 days. A barium enema resolved the intussusception. The patient was discharged from the hospital on 23-SEP-2007. On 24-SEP-2007 the patient was seen in the physician''s office and the physician stated the patient had been vomiting, but with no dehydration. The patient had a bowel movement with no blood in the stools. Therapy with Rotateq was discontinued on 08-AUG-2007. The physician stated the patient was recovering. There was no product quality complaint. Additional information has been requested.8/4/08-records received for DOS 9/21-9/23/07-DC DX: Intussusception. Presented to ED with C/O vomiting and loose bowel movement times 1-2 days. Crying, irritable.


Changed on 9/14/2018

VAERS ID: 309001 Before After
VAERS Form:1
Age:0.38
Sex:Female
Location:Pennsylvania
Vaccinated:2007-08-08
Onset:2007-09-21
Submitted:2008-04-04
Entered:2008-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0240U / 2 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Crying, Diarrhoea, Intussusception, Vomiting

Life Threatening? No
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
Allergies:
Diagnostic Lab Data: barium enema X-ray 09/21/07 - intussusception resolved 8/4/08-records received- US confirmed intussusception in right upper quadrant. Therapeutic contrast enema, successful reduction of ileocolic intussusception.
CDC 'Split Type': WAES0803USA04735

Write-up: Information has been received from a physician concerning a 26 week old female who on 25-MAY-2007 and 08-AUG-2007 was vaccinated PO with her first and second 2.0 ml doses of Rotateq (lot# "12337," 656393/0240U). On 21-SEP-2007 the patient was seen in the physician''s office since the patient experienced vomiting, crying and loose stools. The patient did not have bloody stools. The patient was admitted to a hospital that same day and was diagnosed with intussusception. The patient was hospitalized for 3 days. A barium enema resolved the intussusception. The patient was discharged from the hospital on 23-SEP-2007. On 24-SEP-2007 the patient was seen in the physician''s office and the physician stated the patient had been vomiting, but with no dehydration. The patient had a bowel movement with no blood in the stools. Therapy with Rotateq was discontinued on 08-AUG-2007. The physician stated the patient was recovering. There was no product quality complaint. Additional information has been requested.8/4/08-records received for DOS 9/21-9/23/07-DC DX: Intussusception. Presented to ED with C/O vomiting and loose bowel movement times 1-2 days. Crying, irritable.


Changed on 10/14/2018

VAERS ID: 309001 Before After
VAERS Form:1
Age:0.38
Sex:Female
Location:Pennsylvania
Vaccinated:2007-08-08
Onset:2007-09-21
Submitted:2008-04-04
Entered:2008-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0240U / 2 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Crying, Diarrhoea, Intussusception, Vomiting

Life Threatening? No
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
Allergies:
Diagnostic Lab Data: barium enema X-ray 09/21/07 - intussusception resolved 8/4/08-records received- US confirmed intussusception in right upper quadrant. Therapeutic contrast enema, successful reduction of ileocolic intussusception.
CDC 'Split Type': WAES0803USA04735

Write-up: Information has been received from a physician concerning a 26 week old female who on 25-MAY-2007 and 08-AUG-2007 was vaccinated PO with her first and second 2.0 ml doses of Rotateq (lot# "12337," 656393/0240U). On 21-SEP-2007 the patient was seen in the physician''s office since the patient experienced vomiting, crying and loose stools. The patient did not have bloody stools. The patient was admitted to a hospital that same day and was diagnosed with intussusception. The patient was hospitalized for 3 days. A barium enema resolved the intussusception. The patient was discharged from the hospital on 23-SEP-2007. On 24-SEP-2007 the patient was seen in the physician''s office and the physician stated the patient had been vomiting, but with no dehydration. The patient had a bowel movement with no blood in the stools. Therapy with Rotateq was discontinued on 08-AUG-2007. The physician stated the patient was recovering. There was no product quality complaint. Additional information has been requested.8/4/08-records received for DOS 9/21-9/23/07-DC DX: Intussusception. Presented to ED with C/O vomiting and loose bowel movement times 1-2 days. Crying, irritable.

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