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This is VAERS ID 383987

History of Changes from the VAERS Wayback Machine

First Appeared on 4/7/2010

VAERS ID: 383987
VAERS Form:
Age:0.3
Sex:Unknown
Location:California
Vaccinated:2010-02-23
Onset:2010-03-02
Submitted:2010-03-31
Entered:2010-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR - / - UN / UN
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC - / - UN / UN
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 0 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Barium double contrast, Crying, Intussusception, Laboratory test

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': WAES1003USA03773

Write-up: Information has been received from a physician concerning a 12 week old patient who "last month", on approximately 23-FEB-2010, was vaccinated with a first dose of ROTATEQ (oral route, lot # unknown). Concomitant therapy included PENTACEL and PREVNAR (lot # not reported) also administered "last month". The physician reported that "a week after getting the vaccines", on approximately 02-MAR-2010, the patient was crying and was taken to the hospital, the patient was diagnosed with intussusception, was admitted and treated with Air contrast enema and the intussusception resolved. Lab diagnostic studies performed were unspecified. The patient was seen last month for a follow-up visit and the patient had recovered. Additional information has been requested.


Changed on 8/31/2010

VAERS ID: 383987 Before After
VAERS Form:
Age:0.3
Sex:Unknown
Location:California
Vaccinated:2010-02-23
Onset:2010-03-02
Submitted:2010-03-31
Entered:2010-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR - / - UN / UN
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH - / - UN / UN
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 0 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Barium double contrast, Crying, Intussusception, Laboratory test

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': WAES1003USA03773

Write-up: Information has been received from a physician concerning a 12 week old patient who "last month", on approximately 23-FEB-2010, was vaccinated with a first dose of ROTATEQ (oral route, lot # unknown). Concomitant therapy included PENTACEL and PREVNAR (lot # not reported) also administered "last month". The physician reported that "a week after getting the vaccines", on approximately 02-MAR-2010, the patient was crying and was taken to the hospital, the patient was diagnosed with intussusception, was admitted and treated with Air contrast enema and the intussusception resolved. Lab diagnostic studies performed were unspecified. The patient was seen last month for a follow-up visit and the patient had recovered. Additional information has been requested.


Changed on 5/13/2013

VAERS ID: 383987 Before After
VAERS Form:
Age:0.3
Sex:Unknown
Location:California
Vaccinated:2010-02-23
Onset:2010-03-02
Submitted:2010-03-31
Entered:2010-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR - / - UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / - UN / UN
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 0 - / PO
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 0 - / PO

Administered by: Other      Purchased by: Other
Symptoms: Barium double contrast, Crying, Intussusception, Laboratory test

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': WAES1003USA03773

Write-up: Information has been received from a physician concerning a 12 week old patient who "last month", on approximately 23-FEB-2010, was vaccinated with a first dose of ROTATEQ (oral route, lot # unknown). Concomitant therapy included PENTACEL and PREVNAR (lot # not reported) also administered "last month". The physician reported that "a week after getting the vaccines", on approximately 02-MAR-2010, the patient was crying and was taken to the hospital, the patient was diagnosed with intussusception, was admitted and treated with Air contrast enema and the intussusception resolved. Lab diagnostic studies performed were unspecified. The patient was seen last month for a follow-up visit and the patient had recovered. Additional information has been requested.


Changed on 9/14/2017

VAERS ID: 383987 Before After
VAERS Form:(blank) 1
Age:0.3
Sex:Unknown
Location:California
Vaccinated:2010-02-23
Onset:2010-03-02
Submitted:2010-03-31
Entered:2010-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR - / - UNK UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / - UNK UN / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 0 1 - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Barium double contrast, Crying, Intussusception, Laboratory test

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': WAES1003USA03773

Write-up: Information has been received from a physician concerning a 12 week old patient who "last month", on approximately 23-FEB-2010, was vaccinated with a first dose of ROTATEQ (oral route, lot # unknown). Concomitant therapy included PENTACEL and PREVNAR (lot # not reported) also administered "last month". The physician reported that "a week after getting the vaccines", on approximately 02-MAR-2010, the patient was crying and was taken to the hospital, the patient was diagnosed with intussusception, was admitted and treated with Air contrast enema and the intussusception resolved. Lab diagnostic studies performed were unspecified. The patient was seen last month for a follow-up visit and the patient had recovered. Additional information has been requested.


Changed on 2/14/2018

VAERS ID: 383987 Before After
VAERS Form:1
Age:0.3
Sex:Unknown
Location:California
Vaccinated:2010-02-23
Onset:2010-03-02
Submitted:2010-03-31
Entered:2010-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR - / UNK UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / UNK UN / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 1 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Barium double contrast, Crying, Intussusception, Laboratory test

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': WAES1003USA03773

Write-up: Information has been received from a physician concerning a 12 week old patient who "last month", on approximately 23-FEB-2010, was vaccinated with a first dose of ROTATEQ (oral route, lot # unknown). Concomitant therapy included PENTACEL and PREVNAR (lot # not reported) also administered "last month". The physician reported that "a week after getting the vaccines", on approximately 02-MAR-2010, the patient was crying and was taken to the hospital, the patient was diagnosed with intussusception, was admitted and treated with Air contrast enema and the intussusception resolved. Lab diagnostic studies performed were unspecified. The patient was seen last month for a follow-up visit and the patient had recovered. Additional information has been requested.


Changed on 6/14/2018

VAERS ID: 383987 Before After
VAERS Form:1
Age:0.3
Sex:Unknown
Location:California
Vaccinated:2010-02-23
Onset:2010-03-02
Submitted:2010-03-31
Entered:2010-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR - / UNK UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / UNK UN / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 1 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Barium double contrast, Crying, Intussusception, Laboratory test

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': WAES1003USA03773

Write-up: Information has been received from a physician concerning a 12 week old patient who "last month", on approximately 23-FEB-2010, was vaccinated with a first dose of ROTATEQ (oral route, lot # unknown). Concomitant therapy included PENTACEL and PREVNAR (lot # not reported) also administered "last month". The physician reported that "a week after getting the vaccines", on approximately 02-MAR-2010, the patient was crying and was taken to the hospital, the patient was diagnosed with intussusception, was admitted and treated with Air contrast enema and the intussusception resolved. Lab diagnostic studies performed were unspecified. The patient was seen last month for a follow-up visit and the patient had recovered. Additional information has been requested.


Changed on 8/14/2018

VAERS ID: 383987 Before After
VAERS Form:1
Age:0.3
Sex:Unknown
Location:California
Vaccinated:2010-02-23
Onset:2010-03-02
Submitted:2010-03-31
Entered:2010-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR - / UNK UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / UNK UN / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 1 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Barium double contrast, Crying, Intussusception, Laboratory test

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': WAES1003USA03773

Write-up: Information has been received from a physician concerning a 12 week old patient who "last month", on approximately 23-FEB-2010, was vaccinated with a first dose of ROTATEQ (oral route, lot # unknown). Concomitant therapy included PENTACEL and PREVNAR (lot # not reported) also administered "last month". The physician reported that "a week after getting the vaccines", on approximately 02-MAR-2010, the patient was crying and was taken to the hospital, the patient was diagnosed with intussusception, was admitted and treated with Air contrast enema and the intussusception resolved. Lab diagnostic studies performed were unspecified. The patient was seen last month for a follow-up visit and the patient had recovered. Additional information has been requested.


Changed on 9/14/2018

VAERS ID: 383987 Before After
VAERS Form:1
Age:0.3
Sex:Unknown
Location:California
Vaccinated:2010-02-23
Onset:2010-03-02
Submitted:2010-03-31
Entered:2010-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR - / UNK UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / UNK UN / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 1 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Barium double contrast, Crying, Intussusception, Laboratory test

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': WAES1003USA03773

Write-up: Information has been received from a physician concerning a 12 week old patient who "last month", on approximately 23-FEB-2010, was vaccinated with a first dose of ROTATEQ (oral route, lot # unknown). Concomitant therapy included PENTACEL and PREVNAR (lot # not reported) also administered "last month". The physician reported that "a week after getting the vaccines", on approximately 02-MAR-2010, the patient was crying and was taken to the hospital, the patient was diagnosed with intussusception, was admitted and treated with Air contrast enema and the intussusception resolved. Lab diagnostic studies performed were unspecified. The patient was seen last month for a follow-up visit and the patient had recovered. Additional information has been requested.


Changed on 10/14/2018

VAERS ID: 383987 Before After
VAERS Form:1
Age:0.3
Sex:Unknown
Location:California
Vaccinated:2010-02-23
Onset:2010-03-02
Submitted:2010-03-31
Entered:2010-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR - / UNK UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / UNK UN / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 1 MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Barium double contrast, Crying, Intussusception, Laboratory test

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': WAES1003USA03773

Write-up: Information has been received from a physician concerning a 12 week old patient who "last month", on approximately 23-FEB-2010, was vaccinated with a first dose of ROTATEQ (oral route, lot # unknown). Concomitant therapy included PENTACEL and PREVNAR (lot # not reported) also administered "last month". The physician reported that "a week after getting the vaccines", on approximately 02-MAR-2010, the patient was crying and was taken to the hospital, the patient was diagnosed with intussusception, was admitted and treated with Air contrast enema and the intussusception resolved. Lab diagnostic studies performed were unspecified. The patient was seen last month for a follow-up visit and the patient had recovered. Additional information has been requested.

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