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This is VAERS ID 379327

History of Changes from the VAERS Wayback Machine

First Appeared on 2/5/2010

VAERS ID: 379327
VAERS Form:
Age:0.5
Sex:Male
Location:New York
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2010-02-03
Entered:2010-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 2 UN / UN

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1001USA03375

Write-up: Information has been received from a physician concerning a 6 month old male who was vaccinated with three doses of ROTATEQ. Two weeks after the third dose, the patient was hospitalized with intussusception. This occurred a few months ago. The patient had surgery, and was fine at the time of report. Intussusception was considered to be immediately life-threatening, and an other important medical event. Additional information has been requested.


Changed on 3/2/2010

VAERS ID: 379327 Before After
VAERS Form:
Age:0.5
Sex:Male
Location:New York
Vaccinated:0000-00-00 2009-03-30
Onset:0000-00-00 2009-04-14
Submitted:2010-02-03
Entered:2010-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - 1269X / 2 UN / UN

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 0 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1001USA03375

Write-up: Information has been received from a physician concerning a 6 month old male who was vaccinated with three doses of ROTATEQ. Two weeks after the third dose, the patient was hospitalized with intussusception. This occurred a few months ago. The patient had surgery, and was fine at the time of report. Intussusception was considered to be immediately life-threatening, and an other important medical event. Additional event.Additional information has been requested. requested


Changed on 4/13/2011

VAERS ID: 379327 Before After
VAERS Form:
Age:0.5
Sex:Male
Location:New York
Vaccinated:2009-03-30
Onset:2009-04-14
Submitted:2010-02-03
Entered:2010-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1269X / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Barium double contrast, Constipation, Cough, Intussusception, Irritability, Lethargy, Pyrexia, Rhinorrhoea, Surgery, Ultrasound abdomen abnormal, Decreased appetite, Metabolic function test

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1001USA03375

Write-up: Information has been received from a physician concerning a 6 month old male who was vaccinated with three doses of ROTATEQ. Two weeks after the third dose, the patient was hospitalized with intussusception. This occurred a few months ago. The patient had surgery, and was fine at the time of report. Intussusception was considered to be immediately life-threatening, and an other important medical event.Additional information has been requested


Changed on 5/13/2011

VAERS ID: 379327 Before After
VAERS Form:
Age:0.5
Sex:Male
Location:New York
Vaccinated:2009-03-30
Onset:2009-04-14
Submitted:2010-02-03
Entered:2010-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1269X / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Barium double contrast, Constipation, Cough, Intussusception, Irritability, Lethargy, Pyrexia, Rhinorrhoea, Surgery, Ultrasound abdomen abnormal, Decreased appetite, Metabolic function test

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1001USA03375

Write-up: Information has been received from a physician concerning a 6 month old male who was vaccinated with three doses of ROTATEQ. Two weeks after the third dose, the patient was hospitalized with intussusception. This occurred a few months ago. The patient had surgery, and was fine at the time of report. Intussusception was considered to be immediately life-threatening, and an other important medical event.Additional information has been requested


Changed on 6/11/2011

VAERS ID: 379327 Before After
VAERS Form:
Age:0.5
Sex:Male
Location:New York
Vaccinated:2009-03-30
Onset:2009-04-14
Submitted:2010-02-03
Entered:2010-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1269X / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Barium double contrast, Constipation, Cough, Intussusception, Irritability, Lethargy, Pyrexia, Rhinorrhoea, Surgery, Ultrasound abdomen abnormal, Decreased appetite, Metabolic function test

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1001USA03375

Write-up: Information has been received from a physician concerning a 6 month old male who was vaccinated with three doses of ROTATEQ. Two weeks after the third dose, the patient was hospitalized with intussusception. This occurred a few months ago. The patient had surgery, and was fine at the time of report. Intussusception was considered to be immediately life-threatening, and an other important medical event.Additional information has been requested


Changed on 2/13/2013

VAERS ID: 379327 Before After
VAERS Form:
Age:0.5
Sex:Male
Location:New York
Vaccinated:2009-03-30
Onset:2009-04-14
Submitted:2010-02-03
Entered:2010-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1269X / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Barium double contrast, Constipation, Cough, Intussusception, Irritability, Lethargy, Pyrexia, Rhinorrhoea, Surgery, Ultrasound abdomen abnormal, Decreased appetite, Metabolic function test

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1001USA03375

Write-up: Information has been received from a physician concerning a 6 month old male who was vaccinated with three doses of ROTATEQ. Two weeks after the third dose, the patient was hospitalized with intussusception. This occurred a few months ago. The patient had surgery, and was fine at the time of report. Intussusception was considered to be immediately life-threatening, and an other important medical event.Additional event. Additional information has been requested requested.


Changed on 5/13/2013

VAERS ID: 379327 Before After
VAERS Form:
Age:0.5
Sex:Male
Location:New York
Vaccinated:2009-03-30
Onset:2009-04-14
Submitted:2010-02-03
Entered:2010-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1269X / 2 UN / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1269X / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Barium double contrast, Constipation, Cough, Intussusception, Irritability, Lethargy, Pyrexia, Rhinorrhoea, Surgery, Ultrasound abdomen abnormal, Decreased appetite, Metabolic function test

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1001USA03375

Write-up: Information has been received from a physician concerning a 6 month old male who was vaccinated with three doses of ROTATEQ. Two weeks after the third dose, the patient was hospitalized with intussusception. This occurred a few months ago. The patient had surgery, and was fine at the time of report. Intussusception was considered to be immediately life-threatening, and an other important medical event. Additional information has been requested.


Changed on 6/14/2014

VAERS ID: 379327 Before After
VAERS Form:
Age:0.5
Sex:Male
Location:New York
Vaccinated:2009-03-30
Onset:2009-04-14
Submitted:2010-02-03
Entered:2010-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1269X / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Barium double contrast, Constipation, Cough, Intussusception, Irritability, Lethargy, Pyrexia, Rhinorrhoea, Surgery, Ultrasound abdomen abnormal, Decreased appetite, Metabolic function test

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1001USA03375

Write-up: Information has been received from a physician concerning a 6 month old male who was vaccinated with three doses of ROTATEQ. Two weeks after the third dose, the patient was hospitalized with intussusception. This occurred a few months ago. The patient had surgery, and was fine at the time of report. Intussusception was considered to be immediately life-threatening, and an other important medical event. Additional information has been requested.


Changed on 3/14/2015

VAERS ID: 379327 Before After
VAERS Form:
Age:0.5
Sex:Male
Location:New York
Vaccinated:2009-03-30
Onset:2009-04-14
Submitted:2010-02-03
Entered:2010-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1269X / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Barium double contrast, Constipation, Cough, Intussusception, Irritability, Lethargy, Pyrexia, Rhinorrhoea, Surgery, Ultrasound abdomen abnormal, Decreased appetite, Metabolic function test

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1001USA03375

Write-up: Information has been received from a physician concerning a 6 month old male who was vaccinated with three doses of ROTATEQ. Two weeks after the third dose, the patient was hospitalized with intussusception. This occurred a few months ago. The patient had surgery, and was fine at the time of report. Intussusception was considered to be immediately life-threatening, and an other important medical event. Additional information has been requested.


Changed on 2/14/2017

VAERS ID: 379327 Before After
VAERS Form:
Age:0.5 0.51
Sex:Male
Location:New York
Vaccinated:2009-03-30
Onset:2009-04-14
Submitted:2010-02-03
Entered:2010-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1269X / 2 UN / UN

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1001USA03375

Write-up: Information has been received from a physician concerning a 6 month old male who was vaccinated with three doses of ROTATEQ. Two weeks after the third dose, the patient was hospitalized with intussusception. This occurred a few months ago. The patient had surgery, and was fine at the time of report. Intussusception was considered to be immediately life-threatening, and an other important medical event. Additional information has been requested.


Changed on 9/14/2017

VAERS ID: 379327 Before After
VAERS Form:(blank) 1
Age:0.51
Sex:Male
Location:New York
Vaccinated:2009-03-30
Onset:2009-04-14
Submitted:2010-02-03
Entered:2010-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1269X / 2 3 UN / UN

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1001USA03375

Write-up: Information has been received from a physician concerning a 6 month old male who was vaccinated with three doses of ROTATEQ. Two weeks after the third dose, the patient was hospitalized with intussusception. This occurred a few months ago. The patient had surgery, and was fine at the time of report. Intussusception was considered to be immediately life-threatening, and an other important medical event. Additional information has been requested.


Changed on 2/14/2018

VAERS ID: 379327 Before After
VAERS Form:1
Age:0.51
Sex:Male
Location:New York
Vaccinated:2009-03-30
Onset:2009-04-14
Submitted:2010-02-03
Entered:2010-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1269X / 3 UN / UN

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1001USA03375

Write-up: Information has been received from a physician concerning a 6 month old male who was vaccinated with three doses of ROTATEQ. Two weeks after the third dose, the patient was hospitalized with intussusception. This occurred a few months ago. The patient had surgery, and was fine at the time of report. Intussusception was considered to be immediately life-threatening, and an other important medical event. Additional information has been requested.


Changed on 6/14/2018

VAERS ID: 379327 Before After
VAERS Form:1
Age:0.51
Sex:Male
Location:New York
Vaccinated:2009-03-30
Onset:2009-04-14
Submitted:2010-02-03
Entered:2010-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1269X / 3 UN / UN

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1001USA03375

Write-up: Information has been received from a physician concerning a 6 month old male who was vaccinated with three doses of ROTATEQ. Two weeks after the third dose, the patient was hospitalized with intussusception. This occurred a few months ago. The patient had surgery, and was fine at the time of report. Intussusception was considered to be immediately life-threatening, and an other important medical event. Additional information has been requested.


Changed on 8/14/2018

VAERS ID: 379327 Before After
VAERS Form:1
Age:0.51
Sex:Male
Location:New York
Vaccinated:2009-03-30
Onset:2009-04-14
Submitted:2010-02-03
Entered:2010-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1269X / 3 UN / UN

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1001USA03375

Write-up: Information has been received from a physician concerning a 6 month old male who was vaccinated with three doses of ROTATEQ. Two weeks after the third dose, the patient was hospitalized with intussusception. This occurred a few months ago. The patient had surgery, and was fine at the time of report. Intussusception was considered to be immediately life-threatening, and an other important medical event. Additional information has been requested.


Changed on 9/14/2018

VAERS ID: 379327 Before After
VAERS Form:1
Age:0.51
Sex:Male
Location:New York
Vaccinated:2009-03-30
Onset:2009-04-14
Submitted:2010-02-03
Entered:2010-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1269X / 3 UN / UN

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1001USA03375

Write-up: Information has been received from a physician concerning a 6 month old male who was vaccinated with three doses of ROTATEQ. Two weeks after the third dose, the patient was hospitalized with intussusception. This occurred a few months ago. The patient had surgery, and was fine at the time of report. Intussusception was considered to be immediately life-threatening, and an other important medical event. Additional information has been requested.


Changed on 10/14/2018

VAERS ID: 379327 Before After
VAERS Form:1
Age:0.51
Sex:Male
Location:New York
Vaccinated:2009-03-30
Onset:2009-04-14
Submitted:2010-02-03
Entered:2010-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1269X / 3 UN / UN

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1001USA03375

Write-up: Information has been received from a physician concerning a 6 month old male who was vaccinated with three doses of ROTATEQ. Two weeks after the third dose, the patient was hospitalized with intussusception. This occurred a few months ago. The patient had surgery, and was fine at the time of report. Intussusception was considered to be immediately life-threatening, and an other important medical event. Additional information has been requested.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=379327&WAYBACKHISTORY=ON


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