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| VAERS ID: | 195443 (history) | Vaccinated: | 1995-11-13 | | Age: | 0.2 | Onset: | 0000-00-00 | | Gender: | Male | Submitted: | 0000-00-00 | | Location: | Indiana | Entered: | 2002-12-26 | |
| Life Threatening? No |
| Died? No |
| Permanent Disability? Yes |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: | | Current Illness: | | Preexisting Conditions: | | Diagnostic Lab Data: | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | DTP: DTP (NO BRAND NAME) | CONNAUGHT LABORATORIES | 4AH082 | | | RL | | HEP: HEP B (RECOMBIVAX HB) | MERCK & CO. INC. | 1291A | | | LL | | HIBV: HIB (NO BRAND NAME) | UNKNOWN MANUFACTURER | W520LA | | | RL | | ROTHB5: ROTAVIRUS (ROTATEQ) | MERCK & CO. INC. | 0726F | | PO | | |
| Administered by: Public Purchased by: Private | Symptoms: Abnormal behaviour,
Eye disorder,
Mental retardation severity unspecified,
Neurodevelopmental disorder,
Tooth hypoplasia SMQs:, Dementia (broad), Congenital, familial and genetic disorders (narrow), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (broad), Corneal disorders (broad), Retinal disorders (broad)
| | Write-up: He did things on time and other things not on time while at the same time forgetting things . Noticed since real little 3 months old. Getting help and treatment at Rehab center. 7 months old when noticed alot of not paying attention. he really went backwards at 18 months old. 60 day follow up states pt has not recovered. His eye have a disease in them (one wants to cross). his teeth #3 underbite. His learning is always going to be difficult. is stool unlesson a diet and certain minerals etc is always going to be a problem. He acts up at times and speech. For only having one child things have been up and down. Everybody thought he was a monster at age 2. Dirty looks and jokes at least he doesn''t remember that. Things are better now but I sure went through hell for about 3 1/2 years and was extremely stressed out. |
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| VAERS ID: | 253960 (history) | Vaccinated: | 2006-03-17 | | Age: | 0.3 | Onset: | 2006-03-24, Days after vaccination: 7 | | Gender: | Male | Submitted: | 2006-03-28, Days after onset: 4 | | Location: | Nebraska | Entered: | 2006-04-11, Days after submission: 13 | |
| Life Threatening? No |
| Died? No |
| Permanent Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: NONE | | Current Illness: NONE | | Preexisting Conditions: NONE | | Diagnostic Lab Data: NONE | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | DTAP: DTAP (DAPTACEL) | SANOFI PASTEUR | C239 | 1 | IM | | | HBHEPB: HIB + HEP B (COMVAX) | MERCK & CO. INC. | 1192R | 1 | IM | | | IPV: POLIO VIRUS, INACT. (IPOL) | SANOFI PASTEUR | Y0576 | 1 | IM | | | PNC: PNEUMO (PREVNAR) | PFIZER/WYETH | B08642 | 1 | IM | | | ROTHB5: ROTAVIRUS (ROTATEQ) | MERCK & CO. INC. | 0139F | 0 | PO | | |
| Administered by: Private Purchased by: Public | Symptoms: Purpura,
Rash generalised,
Rhinorrhoea,
Roseola,
Teething,
Urticaria SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow)
| | Write-up: Rash slightly purpuric, becoming urticarial. Persistent until fluids started 4/6/06. Information has been received from a mother, a physicain and medical records concerning a 17-week-old male with teething and a history of gastrenteritis and no allergies who on 17-MAR-2006 at 14:30 was vaccinated PO with the first dose of ROTAVIRUS vaccine live (lot # 653754/0139P). Suspect vaccinations administered on that same day at 14:30 included the second IM dose of DEPTACEL (lot #C239), the second IM dose of PREVNAR (lot # B08642), the second IM dose of HEPATITIS B (lot # 653524/1192R) and the second IM dose of IPOL (lot # Y0576). There was no illness at the time of vaccination. The mother reported that on 18-MAR-2006, her son developed a rash on his legs. The rash was characterized by red, nickel size blotches. The mother described the "hives" as light pink in the center, dark pink on the outside and all different sizes and shapes. The physician described the patient''s rash as a fine pinhead purpuric rash which progressed to a urticarial rash. There was no itching or fever. On 21-MAR-2006 the patient was seen in the Emergency room, but was not admitted to the hospital. The patient was diagnosed with roseola at the ER. No laboratory/diagnostic tests were performed. On 22-MAR-2006 the patient was seen by the physician as his rash persisted. At the time, there was no blood in the stool. On 24-MAR-2006, the patient was seen again by the physician to re-check the rash on his hand. Since the time of onset, the rash had spread to the rest of the patient''s body. It was noted that BENADRYL cleared the rash for the first few days, but wasnot effective after that. PREDNISONE was then prescribed to treat the patient''s rash. On 26-MAR-2006, the patient was seen by another physician. At that time the patient had no feverm vomiting, diarrhea or difficulty breathing and appeared to be well hydrated. The patient was noted to have normal skin turgor, no lesions. He had a duffuse red pinpoint rash over his body with areas of hived and urticaria spread over the turso and extremities. The patient had more purple skin between lesions and thicker areas of hives, No petechia or purpura was noted at that time. The patient was encouraged to rest and consume fluids. On 11-APR-2006, the patient''s purpuric red rash and urticaria resolved. Medical records also contained the following adverse event; runny nose (March 2006). This is a consolidation of two reports from the same patient. No further information is available. All available medical records will be provided upon request. It has been determined that WAES 0605USA00810 is a duplicate of WAES 0604USA00541. Therefore, WAES 0505USA00810 is being deleted from our files and the reports consolidated into WAES # 0604USA00541 for ROTAVIRUS vaccine live. |
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| VAERS ID: | 254120 (history) | Vaccinated: | 0000-00-00 | | Age: | | Onset: | 0000-00-00 | | Gender: | Unknown | Submitted: | 2006-04-10 | | Location: | Unknown | Entered: | 2006-04-14, Days after submission: 4 | |
| Life Threatening? No |
| Died? No |
| Permanent Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: UNK | | Current Illness: | | Preexisting Conditions: UNK | | Diagnostic Lab Data: UNK | | CDC 'Split Type': WAES0603USA01662 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | ROTHB5: ROTAVIRUS (ROTATEQ) | MERCK & CO. INC. | | | PO | | |
| Administered by: Other Purchased by: Other | Symptoms: Pyrexia SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
| | Write-up: Information has been received from a physician concerning 3-4 infants who in 2006 were vaccinated PO with a dose of rotavirus G1 G2 G3 G4 P1 reassortant vaccine live. The physician reported that in 2006, the infants developed a fever after vaccination. Unspecified medical attention was sought. Subsequently, the fevers resolved. Additional information has been requested. |
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| VAERS ID: | 254121 (history) | Vaccinated: | 2006-03-14 | | Age: | 0.2 | Onset: | 2006-03-15, Days after vaccination: 1 | | Gender: | Female | Submitted: | 2006-04-10, Days after onset: 25 | | Location: | North Carolina | Entered: | 2006-04-14, Days after submission: 4 | |
| Life Threatening? No |
| Died? No |
| Permanent Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: | | Current Illness: | | Preexisting Conditions: Pneumothorax; Hospitalization; Sacral dimple congenital; Nuclear magnetic resonance imaging | | Diagnostic Lab Data: NONE | | CDC 'Split Type': WAES0603USA02502 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) | GLAXOSMITHKLINE BIOLOGICALS | | | UN | UN | | HIBV: HIB (PEDVAXHIB) | MERCK & CO. INC. | | | UN | UN | | PNC: PNEUMO (PREVNAR) | PFIZER/WYETH | | | UN | UN | | ROTHB5: ROTAVIRUS (ROTATEQ) | MERCK & CO. INC. | 0145F | 0 | PO | | |
| Administered by: Private Purchased by: Private | Symptoms: Haematochezia SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad)
| | Write-up: Information has been received from a registered nurse concerning an 8 week old female (born at 37.4 weeks gestation at 2396 grams) with a history of a NICU admission (3 days) at the time of birth due to a right pneumothorax (unspecified cause) and a normal MRI of the lumbar spine done for a sacral dimple who on 3/14/06 was vaccinated, PO, with the first 2.0 mL dose of ROTETEQ (lot 0145F). Concomitant vaccinations administered on that same day include a dose of PEDIARIX and PEDVAX HB and a dose of PREVNAR. There was no other concomitant therapy at the time of vaccination. The RN reported that on 3/15/06, the patient''s mother called the office reporting her daughter had a bloody stool as she had blood in her diaper. The patient''s mother indicated that she did not test the stools with guiac paper for blood. No other symptoms were reported. The RN indicated she had spoken with the patient''s mother several times since 3/15/06 and the child did not have any other occurrences of blood in her stool. At the time of this report, the patient was noted to be well and was considered to be recovered. Additional information has been requested. Information has been received from a registered nurse (RN) concerning an 8-week-old female (born 37.4 weeks gestation at 2396 grams) a with a history of a NICU admission (3 days) at the time of birth due to a right pneumothorax (unspecified cause) and a normal MRI of the lumbar spine done for a sacral dimple who, at her 2-month check-up, on 14-MAR-2006, at approximately 1200, was vaccinated, PO, with the first 2.0 mL dose of ROTATEQ (Lot #652964/0145F). Concomitant vaccinations administered on that same day included a dose of PEDIARIX a dose of PREVNAR. Ther was no illness or other concomitant therapy at the time of vaccination. The RN reported the patient''s mother called the physician''s office indicating that on 15-MAR-2006, at about 0955, her daughter had a bloody stool as she had a small amount of blood in the stool in her diaper. The patient''s mother indicated that she did not test the stools with guiac paper for blood. No other symptoms were reported and no laboratory/diagnostic tests were performed. The patient did not require an Emergency Room or doctor visit. The patient was not hospitalized. The mother was advised to monitor her daughter and report any abnormal pain or vomiting. The patient''s mother indicated that her daughter''s nex stool was normal. As of 16-MAR-2006, the patient was noted to be well and was considered to be recovered. The RN indicated that she has spoken with the patient''s mother several times since 15-MAR-2006 and the child did not have any other occurrences of blood in her stool. No further information is available. |
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| VAERS ID: | 254122 (history) | Vaccinated: | 2006-03-17 | | Age: | 0.3 | Onset: | 2006-03-17, Days after vaccination: 0 | | Gender: | Unknown | Submitted: | 2006-04-10, Days after onset: 23 | | Location: | California | Entered: | 2006-04-14, Days after submission: 4 | |
| Life Threatening? No |
| Died? No |
| Permanent Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: UNK | | Current Illness: | | Preexisting Conditions: UNK | | Diagnostic Lab Data: Stool rotavirus RNA: positive. | | CDC 'Split Type': WAES0603USA04519 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | ROTHB5: ROTAVIRUS (ROTATEQ) | MERCK & CO. INC. | 0139F | 0 | | | |
| Administered by: Other Purchased by: Other | Symptoms: Diarrhoea,
Respiratory syncytial virus infection,
Viral infection SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
| | Write-up: Information has been received from a receptionist in a physician''s office concerning a child (age noted to be between 6-12 weeks) who in March 2006, was vaccinated with the first dose of rotavirus G1 G2 G3 G4 P1 reassortant vaccine live. The physician reported that in march 2006, the day after vaccination, the patient developed diarrhea which lasted 12 days. Unspecified medical attention was sought. The child was tested for rotavirus and the results were positive. At the time of this report, the outcome was unknown. Additional information has been requested. |
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| VAERS ID: | 255125 (history) | Vaccinated: | 2006-03-06 | | Age: | 0.4 | Onset: | 2006-03-17, Days after vaccination: 11 | | Gender: | Male | Submitted: | 2006-05-05, Days after onset: 48 | | Location: | Wisconsin | Entered: | 2006-05-05 | |
| Life Threatening? No |
| Died? No |
| Permanent Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: | | Current Illness: NONE | | Preexisting Conditions: Eczema | | Diagnostic Lab Data: NONE | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | DTAP: DTAP (DAPTACEL) | SANOFI PASTEUR | C2405AA | 1 | IM | UN | | HIBV: HIB (PEDVAXHIB) | MERCK & CO. INC. | 0621R | 1 | IM | LL | | IPV: POLIO VIRUS, INACT. (IPOL) | SANOFI PASTEUR | Y0576 | 1 | IM | UN | | PNC: PNEUMO (PREVNAR) | PFIZER/WYETH | 1308639A | 2 | | | | ROTHB5: ROTAVIRUS (ROTATEQ) | MERCK & CO. INC. | 0139F | 0 | PO | | |
| Administered by: Private Purchased by: Private | Symptoms: Diarrhoea SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
| | Write-up: Had diarrhea 6-10 days after Rotateq very watery deferred vaccines in future. |
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| VAERS ID: | 255442 (history) | Vaccinated: | 2006-03-15 | | Age: | | Onset: | 2006-03-15, Days after vaccination: 0 | | Gender: | Unknown | Submitted: | 2006-05-10, Days after onset: 55 | | Location: | Wisconsin | Entered: | 2006-05-15, Days after submission: 5 | |
| Life Threatening? No |
| Died? No |
| Permanent Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: UNK | | Current Illness: | | Preexisting Conditions: UNK | | Diagnostic Lab Data: | | CDC 'Split Type': 8WAES0604USA01566 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | ROTHB5: ROTAVIRUS (ROTATEQ) | MERCK & CO. INC. | | | | | |
| Administered by: Other Purchased by: Other | Symptoms: Lethargy,
Vomiting SMQs:, Acute pancreatitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
| | Write-up: Info has been received from a physician concerning a pediatric pt who on 3/15/06 was vaccinated with a dose of rotavirus 01 02 03 F1 reassortant vaccine live (Human-bovine). The physician reported that on 3/15/06, the pt developed vomiting and lethargy. Unspecified medical attention was sought. Subsequently, the pt''s vomiting and lethargy resolved. Additional info has been requested. |
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| VAERS ID: | 255443 (history) | Vaccinated: | 0000-00-00 | | Age: | | Onset: | 0000-00-00 | | Gender: | Female | Submitted: | 2006-05-10 | | Location: | North Dakota | Entered: | 2006-05-15, Days after submission: 5 | |
| Life Threatening? No |
| Died? No |
| Permanent Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: UNK | | Current Illness: | | Preexisting Conditions: UNK | | Diagnostic Lab Data: UNK | | CDC 'Split Type': WAES0604USA02313 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | ROTHB5: ROTAVIRUS (ROTATEQ) | MERCK & CO. INC. | | | | | |
| Administered by: Other Purchased by: Other | Symptoms: Eye pain SMQs:, Glaucoma (broad)
| | Write-up: Info has been received from an RN concerning another female nurse who had a pt spit rotavirus G1 02 03 04 P1 reassortant vaccine live (human-bovine) into her eye. The RN reported that the nurse had some burning in her eye. Unspecified medical attention was sought and it was noted that the nurse did not wash her eye. At the time of this report, the outcome was unknown. Additional info has been requested. |
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| VAERS ID: | 255444 (history) | Vaccinated: | 2006-04-12 | | Age: | 1.7 | Onset: | 2006-04-12, Days after vaccination: 0 | | Gender: | Unknown | Submitted: | 2006-05-10, Days after onset: 28 | | Location: | Virginia | Entered: | 2006-05-15, Days after submission: 5 | |
| Life Threatening? No |
| Died? No |
| Permanent Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: Unknown | | Current Illness: | | Preexisting Conditions: Unknown | | Diagnostic Lab Data: UNK | | CDC 'Split Type': WAES0804USA02581 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | ROTHB5: ROTAVIRUS (ROTATEQ) | MERCK & CO. INC. | | 0 | PO | | |
| Administered by: Other Purchased by: Other | Symptoms: Unevaluable event SMQs:
| | Write-up: Information has been received from a registered nurse (RN) concerning an 8-month-old infant who on 12-APR-2006, was vaccinated PO with the 1st dose of ROTATEQ. Unspecified medical attention was sought, but no adverse events were reported. Additional information has been requested. |
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| VAERS ID: | 255445 (history) | Vaccinated: | 0000-00-00 | | Age: | 0.3 | Onset: | 0000-00-00 | | Gender: | Unknown | Submitted: | 2006-05-10 | | Location: | Virginia | Entered: | 2006-05-15, Days after submission: 5 | |
| Life Threatening? No |
| Died? No |
| Permanent Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: UNK | | Current Illness: | | Preexisting Conditions: UNK | | Diagnostic Lab Data: UNK | | CDC 'Split Type': WAES0604USA03292 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | ROTHB5: ROTAVIRUS (ROTATEQ) | MERCK & CO. INC. | | | PO | | |
| Administered by: Other Purchased by: Other | Symptoms: Unevaluable event SMQs:
| | Write-up: Info has been received from a physician concerning a few children who in 2006, were vaccinated po with a 2.0 ml dose of rotavirus G1 G2 G3 G4 P1 reassortant vaccine live (human-bovine) at 4 months of age. Unspecified medical attention was sought. No further info is available. |
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