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This is VAERS ID 326527

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2008

VAERS ID: 326527
VAERS Form:
Age:0.2
Sex:Male
Location:California
Vaccinated:2008-07-30
Onset:0000-00-00
Submitted:2008-09-29
Entered:2008-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / - UN / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. - / - UN / UN
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / - UN / UN
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC - / - UN / UN
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0210X / 0 UN / UN

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

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
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 on 30-JUL-2008 was vaccinated with the first dose of ROTATEQ (lot #660681/0210X). Concomitant suspect vaccine therapy included a dose of PEDVAXHIB (manufacturer unknown) and a dose of R"ECOMBIVAX HB (manufacturer unknown). Other concomitant vaccine therapy included a dose of DTAP, IPOL and a dose of PREVNAR. It was reported that the patient was admitted to the hospital and operated on immediately for intussusception (on an unspecified


Changed on 12/8/2009

VAERS ID: 326527 Before After
VAERS Form:
Age:0.2
Sex:Male
Location:California
Vaccinated:2008-07-30
Onset:0000-00-00
Submitted:2008-09-29
Entered:2008-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / - UN / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. - / - UN / UN
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / - UN / UN
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC - / - UN / UN
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0210X / 0 UN / UN

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

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0809USA04296

Write-up: Information has been received from a physician concerning a male who on 30-JUL-2008 was vaccinated with the first dose of ROTATEQ (lot #660681/0210X). Concomitant suspect vaccine therapy included a dose of PEDVAXHIB (manufacturer unknown) and a dose of R"ECOMBIVAX RECOMBIVAX HB (manufacturer unknown). Other concomitant vaccine therapy included a dose of DTAP, IPOL and a dose of PREVNAR. It was reported that the patient was admitted to the hospital and operated on immediately for intussusception (on an unspecified date between 30-JUL-2008 and 24-SEP-2008). The patient has recovered (date not reported). Additional information has been requested.


Changed on 3/2/2010

VAERS ID: 326527 Before After
VAERS Form:
Age:0.2
Sex:Male
Location:California
Vaccinated:2008-07-30
Onset:0000-00-00
Submitted:2008-09-29
Entered:2008-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / - UN / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. - / - UN / UN
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / - UN / UN
PNC: PNEUMO (PREVNAR) PNEUMO (PREVNAR7) / WYETH PHARMACEUTICALS, INC - / - UN / UN
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0210X / 0 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Surgery

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0809USA04296

Write-up: Information has been received from a physician concerning a male who on 30-JUL-2008 was vaccinated with the first dose of ROTATEQ (lot #660681/0210X). Concomitant suspect vaccine therapy included a dose of PEDVAXHIB (manufacturer unknown) and a dose of RECOMBIVAX HB (manufacturer unknown). Other concomitant vaccine therapy included a dose of DTAP, IPOL and a dose of PREVNAR. It was reported that the patient was admitted to the hospital and operated on immediately for intussusception (on an unspecified date between 30-JUL-2008 and 24-SEP-2008). The patient has recovered (date not reported). Additional information has been requested.


Changed on 4/7/2010

VAERS ID: 326527 Before After
VAERS Form:
Age:0.2
Sex:Male
Location:California
Vaccinated:2008-07-30
Onset:0000-00-00
Submitted:2008-09-29
Entered:2008-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / - UN / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. - / - UN / UN
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / - UN / UN
PNC: PNEUMO (PREVNAR7) PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC - / - UN / UN
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0210X / 0 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Surgery

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0809USA04296

Write-up: Information has been received from a physician concerning a male who on 30-JUL-2008 was vaccinated with the first dose of ROTATEQ (lot #660681/0210X). Concomitant suspect vaccine therapy included a dose of PEDVAXHIB (manufacturer unknown) and a dose of RECOMBIVAX HB (manufacturer unknown). Other concomitant vaccine therapy included a dose of DTAP, IPOL and a dose of PREVNAR. It was reported that the patient was admitted to the hospital and operated on immediately for intussusception (on an unspecified date between 30-JUL-2008 and 24-SEP-2008). The patient has recovered (date not reported). Additional information has been requested.


Changed on 8/31/2010

VAERS ID: 326527 Before After
VAERS Form:
Age:0.2
Sex:Male
Location:California
Vaccinated:2008-07-30
Onset:0000-00-00
Submitted:2008-09-29
Entered:2008-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / - UN / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. - / - UN / UN
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / - UN / UN
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH - / - UN / UN
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0210X / 0 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Surgery

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0809USA04296

Write-up: Information has been received from a physician concerning a male who on 30-JUL-2008 was vaccinated with the first dose of ROTATEQ (lot #660681/0210X). Concomitant suspect vaccine therapy included a dose of PEDVAXHIB (manufacturer unknown) and a dose of RECOMBIVAX HB (manufacturer unknown). Other concomitant vaccine therapy included a dose of DTAP, IPOL and a dose of PREVNAR. It was reported that the patient was admitted to the hospital and operated on immediately for intussusception (on an unspecified date between 30-JUL-2008 and 24-SEP-2008). The patient has recovered (date not reported). Additional information has been requested.


Changed on 5/13/2013

VAERS ID: 326527 Before After
VAERS Form:
Age:0.2
Sex:Male
Location:California
Vaccinated:2008-07-30
Onset:0000-00-00
Submitted:2008-09-29
Entered:2008-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / - UN / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. - / - UN / UN
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / - UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / - UN / UN
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0210X / 0 UN / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0210X / 0 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Surgery

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0809USA04296

Write-up: Information has been received from a physician concerning a male who on 30-JUL-2008 was vaccinated with the first dose of ROTATEQ (lot #660681/0210X). Concomitant suspect vaccine therapy included a dose of PEDVAXHIB (manufacturer unknown) and a dose of RECOMBIVAX HB (manufacturer unknown). Other concomitant vaccine therapy included a dose of DTAP, IPOL and a dose of PREVNAR. It was reported that the patient was admitted to the hospital and operated on immediately for intussusception (on an unspecified date between 30-JUL-2008 and 24-SEP-2008). The patient has recovered (date not reported). Additional information has been requested.


Changed on 9/14/2017

VAERS ID: 326527 Before After
VAERS Form:(blank) 1
Age:0.2
Sex:Male
Location:California
Vaccinated:2008-07-30
Onset:0000-00-00
Submitted:2008-09-29
Entered:2008-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK UN / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / - UNK UN / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. - / - UNK UN / UN
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / - UNK UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / - UNK UN / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0210X / 0 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Surgery

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0809USA04296

Write-up: Information has been received from a physician concerning a male who on 30-JUL-2008 was vaccinated with the first dose of ROTATEQ (lot #660681/0210X). Concomitant suspect vaccine therapy included a dose of PEDVAXHIB (manufacturer unknown) and a dose of RECOMBIVAX HB (manufacturer unknown). Other concomitant vaccine therapy included a dose of DTAP, IPOL and a dose of PREVNAR. It was reported that the patient was admitted to the hospital and operated on immediately for intussusception (on an unspecified date between 30-JUL-2008 and 24-SEP-2008). The patient has recovered (date not reported). Additional information has been requested.


Changed on 2/14/2018

VAERS ID: 326527 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:California
Vaccinated:2008-07-30
Onset:0000-00-00
Submitted:2008-09-29
Entered:2008-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / UNK UN / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. - / UNK UN / UN
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / UNK UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / UNK UN / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0210X / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Surgery

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0809USA04296

Write-up: Information has been received from a physician concerning a male who on 30-JUL-2008 was vaccinated with the first dose of ROTATEQ (lot #660681/0210X). Concomitant suspect vaccine therapy included a dose of PEDVAXHIB (manufacturer unknown) and a dose of RECOMBIVAX HB (manufacturer unknown). Other concomitant vaccine therapy included a dose of DTAP, IPOL and a dose of PREVNAR. It was reported that the patient was admitted to the hospital and operated on immediately for intussusception (on an unspecified date between 30-JUL-2008 and 24-SEP-2008). The patient has recovered (date not reported). Additional information has been requested.


Changed on 6/14/2018

VAERS ID: 326527 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:California
Vaccinated:2008-07-30
Onset:0000-00-00
Submitted:2008-09-29
Entered:2008-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / UNK UN / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. - / UNK UN / UN
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / UNK UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / UNK UN / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0210X / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Surgery

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0809USA04296

Write-up: Information has been received from a physician concerning a male who on 30-JUL-2008 was vaccinated with the first dose of ROTATEQ (lot #660681/0210X). Concomitant suspect vaccine therapy included a dose of PEDVAXHIB (manufacturer unknown) and a dose of RECOMBIVAX HB (manufacturer unknown). Other concomitant vaccine therapy included a dose of DTAP, IPOL and a dose of PREVNAR. It was reported that the patient was admitted to the hospital and operated on immediately for intussusception (on an unspecified date between 30-JUL-2008 and 24-SEP-2008). The patient has recovered (date not reported). Additional information has been requested.


Changed on 8/14/2018

VAERS ID: 326527 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:California
Vaccinated:2008-07-30
Onset:0000-00-00
Submitted:2008-09-29
Entered:2008-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / UNK UN / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. - / UNK UN / UN
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / UNK UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / UNK UN / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0210X / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Surgery

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0809USA04296

Write-up: Information has been received from a physician concerning a male who on 30-JUL-2008 was vaccinated with the first dose of ROTATEQ (lot #660681/0210X). Concomitant suspect vaccine therapy included a dose of PEDVAXHIB (manufacturer unknown) and a dose of RECOMBIVAX HB (manufacturer unknown). Other concomitant vaccine therapy included a dose of DTAP, IPOL and a dose of PREVNAR. It was reported that the patient was admitted to the hospital and operated on immediately for intussusception (on an unspecified date between 30-JUL-2008 and 24-SEP-2008). The patient has recovered (date not reported). Additional information has been requested.


Changed on 9/14/2018

VAERS ID: 326527 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:California
Vaccinated:2008-07-30
Onset:0000-00-00
Submitted:2008-09-29
Entered:2008-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / UNK UN / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. - / UNK UN / UN
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / UNK UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / UNK UN / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0210X / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Surgery

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0809USA04296

Write-up: Information has been received from a physician concerning a male who on 30-JUL-2008 was vaccinated with the first dose of ROTATEQ (lot #660681/0210X). Concomitant suspect vaccine therapy included a dose of PEDVAXHIB (manufacturer unknown) and a dose of RECOMBIVAX HB (manufacturer unknown). Other concomitant vaccine therapy included a dose of DTAP, IPOL and a dose of PREVNAR. It was reported that the patient was admitted to the hospital and operated on immediately for intussusception (on an unspecified date between 30-JUL-2008 and 24-SEP-2008). The patient has recovered (date not reported). Additional information has been requested.


Changed on 10/14/2018

VAERS ID: 326527 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:California
Vaccinated:2008-07-30
Onset:0000-00-00
Submitted:2008-09-29
Entered:2008-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / UNK UN / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. - / UNK UN / UN
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / UNK UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / UNK UN / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0210X / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Intussusception, Surgery

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: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0809USA04296

Write-up: Information has been received from a physician concerning a male who on 30-JUL-2008 was vaccinated with the first dose of ROTATEQ (lot #660681/0210X). Concomitant suspect vaccine therapy included a dose of PEDVAXHIB (manufacturer unknown) and a dose of RECOMBIVAX HB (manufacturer unknown). Other concomitant vaccine therapy included a dose of DTAP, IPOL and a dose of PREVNAR. It was reported that the patient was admitted to the hospital and operated on immediately for intussusception (on an unspecified date between 30-JUL-2008 and 24-SEP-2008). The patient has recovered (date not reported). Additional information has been requested.

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