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This is VAERS ID 157668

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 157668
VAERS Form:
Age:
Sex:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1999-12-10
Entered:2000-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV: ROTASHIELD / WYETH - / - - / PO

Administered by: Other      Purchased by: Unknown
Symptoms: REACT UNEVAL

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up: Physician reported that a pt died following the receipt of RotaShield.


Changed on 12/8/2009

VAERS ID: 157668 Before After
VAERS Form:
Age:
Sex:Unknown Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1999-12-10
Entered:2000-09-18 2000-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV: ROTASHIELD ROTAVIRUS (ROTASHIELD) / WYETH WYETH PHARMACEUTICALS, INC - / - - / PO

Administered by: Other      Purchased by: Unknown Other
Symptoms: Coma, Cyanosis, Dyspnoea, Hypotonia, Nystagmus, Pyrexia, Stridor, Wheezing, Unevaluable event, REACT UNEVAL

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) HQ7644307DEC1999

Write-up: Physician reported that a pt died following the receipt of RotaShield. The baby arrived unresponsive, blue, difficulty in breathing, hypotonic, had vertical nystagmus, had fever, stridor, wheezing, looked cyanotic. .


Changed on 8/31/2010

VAERS ID: 157668 Before After
VAERS Form:
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1999-12-10
Entered:2000-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV: ROTAVIRUS (ROTASHIELD) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH - / - - / PO

Administered by: Other      Purchased by: Other
Symptoms: Coma, Cyanosis, Dyspnoea, Hypotonia, Nystagmus, Pyrexia, Stridor, Wheezing, Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ7644307DEC1999

Write-up: Physician reported that a pt died following the receipt of RotaShield. The baby arrived unresponsive, blue, difficulty in breathing, hypotonic, had vertical nystagmus, had fever, stridor, wheezing, looked cyanotic. .


Changed on 5/14/2017

VAERS ID: 157668 Before After
VAERS Form:
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1999-12-10
Entered:2000-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV: ROTAVIRUS (ROTASHIELD) / PFIZER/WYETH - / - - / PO

Administered by: Other      Purchased by: Other
Symptoms: Coma, Cyanosis, Dyspnoea, Hypotonia, Nystagmus, Pyrexia, Stridor, Wheezing, Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ7644307DEC1999

Write-up: Physician reported that a pt died following the receipt of RotaShield. The baby arrived unresponsive, blue, difficulty in breathing, hypotonic, had vertical nystagmus, had fever, stridor, wheezing, looked cyanotic. .


Changed on 9/14/2017

VAERS ID: 157668 Before After
VAERS Form:(blank) 1
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1999-12-10
Entered:2000-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV: ROTAVIRUS (ROTASHIELD) / PFIZER/WYETH - / - UNK - MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Coma, Cyanosis, Dyspnoea, Hypotonia, Nystagmus, Pyrexia, Stridor, Wheezing, Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ7644307DEC1999

Write-up: Physician reported that a pt died following the receipt of RotaShield. The baby arrived unresponsive, blue, difficulty in breathing, hypotonic, had vertical nystagmus, had fever, stridor, wheezing, looked cyanotic.


Changed on 2/14/2018

VAERS ID: 157668 Before After
VAERS Form:1
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1999-12-10
Entered:2000-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV: ROTAVIRUS (ROTASHIELD) / PFIZER/WYETH - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Coma, Cyanosis, Dyspnoea, Hypotonia, Nystagmus, Pyrexia, Stridor, Wheezing, Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ7644307DEC1999

Write-up: Physician reported that a pt died following the receipt of RotaShield. The baby arrived unresponsive, blue, difficulty in breathing, hypotonic, had vertical nystagmus, had fever, stridor, wheezing, looked cyanotic.


Changed on 6/14/2018

VAERS ID: 157668 Before After
VAERS Form:1
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1999-12-10
Entered:2000-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV: ROTAVIRUS (ROTASHIELD) / PFIZER/WYETH - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Coma, Cyanosis, Dyspnoea, Hypotonia, Nystagmus, Pyrexia, Stridor, Wheezing, Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ7644307DEC1999

Write-up: Physician reported that a pt died following the receipt of RotaShield. The baby arrived unresponsive, blue, difficulty in breathing, hypotonic, had vertical nystagmus, had fever, stridor, wheezing, looked cyanotic.


Changed on 8/14/2018

VAERS ID: 157668 Before After
VAERS Form:1
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1999-12-10
Entered:2000-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV: ROTAVIRUS (ROTASHIELD) / PFIZER/WYETH - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Coma, Cyanosis, Dyspnoea, Hypotonia, Nystagmus, Pyrexia, Stridor, Wheezing, Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ7644307DEC1999

Write-up: Physician reported that a pt died following the receipt of RotaShield. The baby arrived unresponsive, blue, difficulty in breathing, hypotonic, had vertical nystagmus, had fever, stridor, wheezing, looked cyanotic.


Changed on 9/14/2018

VAERS ID: 157668 Before After
VAERS Form:1
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1999-12-10
Entered:2000-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV: ROTAVIRUS (ROTASHIELD) / PFIZER/WYETH - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Coma, Cyanosis, Dyspnoea, Hypotonia, Nystagmus, Pyrexia, Stridor, Wheezing, Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ7644307DEC1999

Write-up: Physician reported that a pt died following the receipt of RotaShield. The baby arrived unresponsive, blue, difficulty in breathing, hypotonic, had vertical nystagmus, had fever, stridor, wheezing, looked cyanotic.


Changed on 10/14/2018

VAERS ID: 157668 Before After
VAERS Form:1
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1999-12-10
Entered:2000-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV: ROTAVIRUS (ROTASHIELD) / PFIZER/WYETH - / UNK MO / PO

Administered by: Other      Purchased by: Other
Symptoms: Coma, Cyanosis, Dyspnoea, Hypotonia, Nystagmus, Pyrexia, Stridor, Wheezing, Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ7644307DEC1999

Write-up: Physician reported that a pt died following the receipt of RotaShield. The baby arrived unresponsive, blue, difficulty in breathing, hypotonic, had vertical nystagmus, had fever, stridor, wheezing, looked cyanotic.

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