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This is VAERS ID 311257

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2008

VAERS ID: 311257
VAERS Form:
Age:0.4
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2008-04-29
Entered:2008-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 0 - / PO

Administered by: Other      Purchased by: Unknown
Symptoms: Intussusception, Laboratory test abnormal, Mucous stools, Surgery, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: diagnostic laboratory, positive currant jelly stool; diagnostic laboratory, intussusception
CDC 'Split Type':

Write-up: Information has been received from a Post-Marketing evaluation program for Rotateq concerning a 5 month old male who was vaccinated PO with her first dose of Rotateq. Subsequently 36 days post dose, the patient was admitted to the hospital with a 3 day h"istory of intractable vomiting and no diarrhea and remained hospitalized for 6 days. Films were performed which showed a positive result for currant jelly stool and intussusception requiring resection. The patient recovered and was discharged on day 6.


Changed on 12/8/2009

VAERS ID: 311257 Before After
VAERS Form:
Age:0.4
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2008-04-29
Entered:2008-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 0 - / PO

Administered by: Other      Purchased by: Unknown Other
Symptoms: Intussusception, Laboratory test abnormal, Mucous stools, Surgery, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: diagnostic laboratory, positive currant jelly stool; diagnostic laboratory, intussusception
CDC 'Split Type': (blank) WAES0804USA05251

Write-up: Information has been received from a Post-Marketing evaluation program for Rotateq concerning a 5 month old male who was vaccinated PO with her first dose of Rotateq. Subsequently 36 days post dose, the patient was admitted to the hospital with a 3 day h"istory history of intractable vomiting and no diarrhea and remained hospitalized for 6 days. Films were performed which showed a positive result for currant jelly stool and intussusception requiring resection. The patient recovered and was discharged on day 6. Intussusception was also considered to be an other important medical event by the reporter. Additional information has been requested.


Changed on 5/13/2013

VAERS ID: 311257 Before After
VAERS Form:
Age:0.4
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2008-04-29
Entered:2008-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 0 - / PO
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 0 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Laboratory test abnormal, Mucous stools, Surgery, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: diagnostic laboratory, positive currant jelly stool; diagnostic laboratory, intussusception
CDC 'Split Type': WAES0804USA05251

Write-up: Information has been received from a Post-Marketing evaluation program for Rotateq concerning a 5 month old male who was vaccinated PO with her first dose of Rotateq. Subsequently 36 days post dose, the patient was admitted to the hospital with a 3 day history of intractable vomiting and no diarrhea and remained hospitalized for 6 days. Films were performed which showed a positive result for currant jelly stool and intussusception requiring resection. The patient recovered and was discharged on day 6. Intussusception was also considered to be an other important medical event by the reporter. Additional information has been requested.


Changed on 9/14/2017

VAERS ID: 311257 Before After
VAERS Form:(blank) 1
Age:0.4
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2008-04-29
Entered:2008-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 0 1 - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Laboratory test abnormal, Mucous stools, Surgery, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: diagnostic laboratory, positive currant jelly stool; diagnostic laboratory, intussusception
CDC 'Split Type': WAES0804USA05251

Write-up: Information has been received from a Post-Marketing evaluation program for Rotateq concerning a 5 month old male who was vaccinated PO with her first dose of Rotateq. Subsequently 36 days post dose, the patient was admitted to the hospital with a 3 day history of intractable vomiting and no diarrhea and remained hospitalized for 6 days. Films were performed which showed a positive result for currant jelly stool and intussusception requiring resection. The patient recovered and was discharged on day 6. Intussusception was also considered to be an other important medical event by the reporter. Additional information has been requested.


Changed on 2/14/2018

VAERS ID: 311257 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2008-04-29
Entered:2008-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 1 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Laboratory test abnormal, Mucous stools, Surgery, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: diagnostic laboratory, positive currant jelly stool; diagnostic laboratory, intussusception
CDC 'Split Type': WAES0804USA05251

Write-up: Information has been received from a Post-Marketing evaluation program for Rotateq concerning a 5 month old male who was vaccinated PO with her first dose of Rotateq. Subsequently 36 days post dose, the patient was admitted to the hospital with a 3 day history of intractable vomiting and no diarrhea and remained hospitalized for 6 days. Films were performed which showed a positive result for currant jelly stool and intussusception requiring resection. The patient recovered and was discharged on day 6. Intussusception was also considered to be an other important medical event by the reporter. Additional information has been requested.


Changed on 6/14/2018

VAERS ID: 311257 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2008-04-29
Entered:2008-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 1 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Laboratory test abnormal, Mucous stools, Surgery, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: diagnostic laboratory, positive currant jelly stool; diagnostic laboratory, intussusception
CDC 'Split Type': WAES0804USA05251

Write-up: Information has been received from a Post-Marketing evaluation program for Rotateq concerning a 5 month old male who was vaccinated PO with her first dose of Rotateq. Subsequently 36 days post dose, the patient was admitted to the hospital with a 3 day history of intractable vomiting and no diarrhea and remained hospitalized for 6 days. Films were performed which showed a positive result for currant jelly stool and intussusception requiring resection. The patient recovered and was discharged on day 6. Intussusception was also considered to be an other important medical event by the reporter. Additional information has been requested.


Changed on 8/14/2018

VAERS ID: 311257 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2008-04-29
Entered:2008-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 1 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Laboratory test abnormal, Mucous stools, Surgery, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: diagnostic laboratory, positive currant jelly stool; diagnostic laboratory, intussusception
CDC 'Split Type': WAES0804USA05251

Write-up: Information has been received from a Post-Marketing evaluation program for Rotateq concerning a 5 month old male who was vaccinated PO with her first dose of Rotateq. Subsequently 36 days post dose, the patient was admitted to the hospital with a 3 day history of intractable vomiting and no diarrhea and remained hospitalized for 6 days. Films were performed which showed a positive result for currant jelly stool and intussusception requiring resection. The patient recovered and was discharged on day 6. Intussusception was also considered to be an other important medical event by the reporter. Additional information has been requested.


Changed on 9/14/2018

VAERS ID: 311257 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2008-04-29
Entered:2008-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 1 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Laboratory test abnormal, Mucous stools, Surgery, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: diagnostic laboratory, positive currant jelly stool; diagnostic laboratory, intussusception
CDC 'Split Type': WAES0804USA05251

Write-up: Information has been received from a Post-Marketing evaluation program for Rotateq concerning a 5 month old male who was vaccinated PO with her first dose of Rotateq. Subsequently 36 days post dose, the patient was admitted to the hospital with a 3 day history of intractable vomiting and no diarrhea and remained hospitalized for 6 days. Films were performed which showed a positive result for currant jelly stool and intussusception requiring resection. The patient recovered and was discharged on day 6. Intussusception was also considered to be an other important medical event by the reporter. Additional information has been requested.


Changed on 10/14/2018

VAERS ID: 311257 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2008-04-29
Entered:2008-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 1 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Laboratory test abnormal, Mucous stools, Surgery, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: diagnostic laboratory, positive currant jelly stool; diagnostic laboratory, intussusception
CDC 'Split Type': WAES0804USA05251

Write-up: Information has been received from a Post-Marketing evaluation program for Rotateq concerning a 5 month old male who was vaccinated PO with her first dose of Rotateq. Subsequently 36 days post dose, the patient was admitted to the hospital with a 3 day history of intractable vomiting and no diarrhea and remained hospitalized for 6 days. Films were performed which showed a positive result for currant jelly stool and intussusception requiring resection. The patient recovered and was discharged on day 6. Intussusception was also considered to be an other important medical event by the reporter. Additional information has been requested.

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