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This is VAERS ID 324591

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2008

VAERS ID: 324591
VAERS Form:
Age:
Gender:Male
Location:Maryland
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2008-09-08
Entered:2008-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / - - / PO

Administered by: Other      Purchased by: Unknown
Symptoms: Intussusception

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: 0     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 male who was vaccinated PO with a 2.0 ml dose of ROTATEQ (date not reported). It was reported that the patient was taken to the hospital due to a case of intussusception after vaccination (date"not reported). The course of treatment and the outcome were not reported. The reporter felt that the intussusception was life-threatening. A product quality complaint was not involved. Additional information has been requested.


Changed on 12/8/2009

VAERS ID: 324591 Before After
VAERS Form:
Age:
Gender:Male
Location:Maryland
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2008-09-08
Entered:2008-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / - - / PO

Administered by: Other      Purchased by: Unknown Other
Symptoms: Intussusception

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: 0     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0809USA00459

Write-up: Information has been received from a physician concerning a male who was vaccinated PO with a 2.0 ml dose of ROTATEQ (date not reported). It was reported that the patient was taken to the hospital due to a case of intussusception after vaccination (date"not (date not reported). The course of treatment and the outcome were not reported. The reporter felt that the intussusception was life-threatening. A product quality complaint was not involved. Additional information has been requested.


Changed on 5/13/2013

VAERS ID: 324591 Before After
VAERS Form:
Age:
Gender:Male
Location:Maryland
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2008-09-08
Entered:2008-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / - - / PO
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / - - / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception

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: 0     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0809USA00459

Write-up: Information has been received from a physician concerning a male who was vaccinated PO with a 2.0 ml dose of ROTATEQ (date not reported). It was reported that the patient was taken to the hospital due to a case of intussusception after vaccination (date not reported). The course of treatment and the outcome were not reported. The reporter felt that the intussusception was life-threatening. A product quality complaint was not involved. Additional information has been requested.


Changed on 9/14/2017

VAERS ID: 324591 Before After
VAERS Form:(blank) 1
Age:
Gender:Male
Location:Maryland
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2008-09-08
Entered:2008-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / - UNK - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception

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: 0     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0809USA00459

Write-up: Information has been received from a physician concerning a male who was vaccinated PO with a 2.0 ml dose of ROTATEQ (date not reported). It was reported that the patient was taken to the hospital due to a case of intussusception after vaccination (date not reported). The course of treatment and the outcome were not reported. The reporter felt that the intussusception was life-threatening. A product quality complaint was not involved. Additional information has been requested.


Changed on 2/14/2018

VAERS ID: 324591 Before After
VAERS Form:1
Age:
Gender:Male
Location:Maryland
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2008-09-08
Entered:2008-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception

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: 0     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0809USA00459

Write-up: Information has been received from a physician concerning a male who was vaccinated PO with a 2.0 ml dose of ROTATEQ (date not reported). It was reported that the patient was taken to the hospital due to a case of intussusception after vaccination (date not reported). The course of treatment and the outcome were not reported. The reporter felt that the intussusception was life-threatening. A product quality complaint was not involved. Additional information has been requested.


Changed on 6/14/2018

VAERS ID: 324591 Before After
VAERS Form:1
Age:
Gender:Male
Location:Maryland
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2008-09-08
Entered:2008-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception

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: 0     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0809USA00459

Write-up: Information has been received from a physician concerning a male who was vaccinated PO with a 2.0 ml dose of ROTATEQ (date not reported). It was reported that the patient was taken to the hospital due to a case of intussusception after vaccination (date not reported). The course of treatment and the outcome were not reported. The reporter felt that the intussusception was life-threatening. A product quality complaint was not involved. Additional information has been requested.


Changed on 8/14/2018

VAERS ID: 324591 Before After
VAERS Form:1
Age:
Gender:Male
Location:Maryland
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2008-09-08
Entered:2008-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception

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: 0     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0809USA00459

Write-up: Information has been received from a physician concerning a male who was vaccinated PO with a 2.0 ml dose of ROTATEQ (date not reported). It was reported that the patient was taken to the hospital due to a case of intussusception after vaccination (date not reported). The course of treatment and the outcome were not reported. The reporter felt that the intussusception was life-threatening. A product quality complaint was not involved. Additional information has been requested.


Changed on 9/14/2018

VAERS ID: 324591 Before After
VAERS Form:1
Age:
Gender:Male
Location:Maryland
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2008-09-08
Entered:2008-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception

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: 0     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0809USA00459

Write-up: Information has been received from a physician concerning a male who was vaccinated PO with a 2.0 ml dose of ROTATEQ (date not reported). It was reported that the patient was taken to the hospital due to a case of intussusception after vaccination (date not reported). The course of treatment and the outcome were not reported. The reporter felt that the intussusception was life-threatening. A product quality complaint was not involved. Additional information has been requested.


Changed on 10/14/2018

VAERS ID: 324591 Before After
VAERS Form:1
Age:
Gender:Male
Location:Maryland
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2008-09-08
Entered:2008-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Intussusception

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: 0     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0809USA00459

Write-up: Information has been received from a physician concerning a male who was vaccinated PO with a 2.0 ml dose of ROTATEQ (date not reported). It was reported that the patient was taken to the hospital due to a case of intussusception after vaccination (date not reported). The course of treatment and the outcome were not reported. The reporter felt that the intussusception was life-threatening. A product quality complaint was not involved. Additional information has been requested.

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