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Found 753 cases where Vaccine is RV5 and Symptom is Intussusception and Appearance Date on/before '2012-04-30'

Case Details

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VAERS ID: 289041 (history)  
Form: Version 1.0  
Age: 0.3  
Gender: Male  
Location: Michigan  
Vaccinated:2007-06-14
Onset:2007-08-04
   Days after vaccination:51
Submitted: 2007-08-20
   Days after onset:16
Entered: 2007-08-27
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B114CA / 2 LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1126F / 2 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08692H / 2 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0236U / 2 MO / PO

Administered by: Private       Purchased by: Private
Symptoms: Abdominal pain, Barium enema, Enema administration, Haematochezia, Intussusception, Mucous stools
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Confirmed by barium enema, Reduced by air enema LABS: Barium enema revealed IS in transverse colon. Air enema reduced. US of abdomen (+) IS recurrence, ileocolic IS & mesenteric adenitis. Blood work WNL.
CDC Split Type:

Write-up: Intussusception - 1 day intermittent symptoms with colicky abdominal pain, blood tinged mucous stool --$g reduced by air enema. 8/28/07 Received pcp medical records which included Hospital D/C summary & H&P. PCP records included vax records but no lot #s. T/C to pcp office, stated info on VAERS report correct & will not provide further info on lot #s. Office visit of 6/14 indicates patient was healthy on day of vax. F/U note of 8/07 indicates patient doing well post op. D/C Summary indicates paitent experienced mucousy emesis, decreased appetite, abdominal pain, fussy, listless & refusal to lie prone x 1 day & bloody mucously stool on day of admit. Admitted 8/4-8/5/07 for observation s/p IS reduction. Overnight, IS recurred as evidenced by (+) US. Then spontaneously resolved. FINAL DX: Intussusception, enema reduced. 9/17/07 Received lab & x-ray reports from hospital.


VAERS ID: 289161 (history)  
Form: Version 1.0  
Age: 0.2  
Gender: Male  
Location: Delaware  
Vaccinated:2007-07-24
Onset:2007-08-19
   Days after vaccination:26
Submitted: 2007-08-23
   Days after onset:4
Entered: 2007-08-28
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2651AA / 1 RL / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 00404 / 2 LL / UN
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF205AA / 1 RL / UN
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR 21069 / 1 LL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B47442H / 1 LL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0551U / 1 MO / PO

Administered by: Private       Purchased by: Private
Symptoms: Abdominal X-ray, Abdominal pain, Barium enema, Chest X-ray, Intussusception, Small intestinal obstruction, Surgery, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None. PMH: 35-36 wk premie with NICU stay for respiratory distress following birth. PE WNL at 2 months
Allergies:
Diagnostic Lab Data: Xray of chest and abdomen. Labs and Diagnostics: Abdominal X-ray concerning for SBO. Contrast enema (+) for intussusception which could not be fully reduced. Blood cultures (-). UC <10,000 Citrobacter koseri.
CDC Split Type:

Write-up: Pt. presented with vomiting and abdominal pain 8/19/07-taken to ER was later admitted to hospital-found to have a small bowel obstruction, not corrected by barium enema, needed to be taken to surgery (Dx: Intussusception) discharged on 8/22/07-all resolved. 9/4/2007 MR rceived from PCP including vax record and hospital D/C summary and labs. Vax record c/w VAERS report. Infant presented 8/20/07 with 1 day hx of decreased feeding, decreased UO, and 3 episodes of NBNB emesis. Abdominal tenderness (+). Contrast enema showed IS but was could not be fully reduced. Taken to OR for Open reduction with incidental appendectomy. Discharged home on POD#2. Diagnosis: Intussusception.


VAERS ID: 289405 (history)  
Form: Version 1.0  
Age: 0.5  
Gender: Male  
Location: Kansas  
Vaccinated:2007-08-03
Onset:2007-08-18
   Days after vaccination:15
Submitted: 2007-08-30
   Days after onset:12
Entered: 2007-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC27B124AA / 3 RA / -
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B47492K / 2 LL / -
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0553U / 3 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Abdominal pain upper, Barium double contrast, Enema administration, Haematochezia, Intussusception, Pain, Vomiting, X-ray
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Other typical 6 month shots
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: x-ray, air enima LABS: US revealed IS. Air enema reduced IS.
CDC Split Type:

Write-up: Intusseption, bloody stool, vomitting of bile, stomach cramps, pain 8/31/07 Received vax record from pcp. VAERS database updated w/same./ss 9/28/07 Vax record faxed to CDC. 10/5/07 T/C to hospital to check status of request. States records faxed directly to CDC on 10/2/07. 10/5/07 Received hospital medical records which reveal patient experienced pallor, decreased bowel sounds, bilious vomiting, blood in stool & abdominal pain. Admitted 8/18-8/19/2007 for observation. Surgery consult done. reduction. Progressed well & d/c to home. FINAL DX: Intussusception.


VAERS ID: 289427 (history)  
Form: Version 1.0  
Age: 0.5  
Gender: Female  
Location: California  
Vaccinated:2007-07-27
Onset:2007-08-18
   Days after vaccination:22
Submitted: 2007-08-30
   Days after onset:12
Entered: 2007-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B110AB / 3 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UE993AA / 3 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08689K / 3 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0778F / 2 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Barium enema, Intussusception
SMQs:, Gastrointestinal obstruction (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations: Intussusception~Rotavirus (Rotateq)~1~0.40~In Patient
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: Barium enema 8-18-07. LABS 2nd hospital: BE revealed IS at mid transverse colon, unsuccessful at reducing IS. CBC & electrolytes were WNL. Blood c/s neg. LABS 3rd hospital: air enema reduced IS.
CDC Split Type:

Write-up: recurrent intussusception 8-18-07 (initial episode 6-07). 9/7/07 Received vax record from pcp which confirm vax all given on 7/27. Vaers database updated w/same. 9/7/07 Reviewed 2nd hospital medical records which reveal patient seen 8/18/07 for 2nd episode of IS. Initial episode 6/07. Presented on 8/18 w/abdominal pain, vomiting & had currant jelly stool in outlying ER. Transferred to higher level of care from 2nd hospital. 9/7/07 Reviewed 3rd hospital medical records which reveal patient admitted 8/18-8/19/07 for abdominal pain, screaming & drawing of legs to chest. Previous IS of 6/07 reduced w/air enema at same facility. Progressed well & was d/c to home. FINAL DX: Intussusception, enema reduced.


VAERS ID: 289592 (history)  
Form: Version 1.0  
Age: 0.3  
Gender: Female  
Location: Virginia  
Vaccinated:2007-07-13
Onset:2007-08-13
   Days after vaccination:31
Submitted: 2007-08-20
   Days after onset:7
Entered: 2007-08-31
   Days after submission:11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B090M / 1 LL / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1435F / 1 RL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08681K / 1 RL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1114F / 1 MO / PO

Administered by: Public       Purchased by: Public
Symptoms: Barium double contrast, Intussusception
SMQs:, Gastrointestinal obstruction (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No Birth HX: c-section due to breech presentation.
Allergies:
Diagnostic Lab Data: Air contrast enema LABS: abdominal series revealed IS. air contrast enema revealed sigmoid colon IS.
CDC Split Type:

Write-up: 4 mo with intussusception. 9/14/07 Reviewed ER medical records which reveal patient experienced vomiting, lethargy & bloody stools x 3 on 8/13/07. DX w/acute GI bleed & transferred to higher level of care. 10/5/07 Received vax record from community health center which confirms lot # but reveals 7/13 dose was 1st dose. VAERS database updated w/same. Vax record faxed to CDC. 10/5/07 Received hospital medical records which reveal patient experienced bloody stools, bilious vomiting, abdominal distention & reduced oral intake x 1 day. Seen in outlying ER & transferred to higher level of care. Admitted 8/13-8/15/2007 for peds surgery. Proximal bowel noted to be significntly dilated & NGT placed for decompression. Able to d/c NGT next day & tolerated oral feeds. Progressed well & d/c to home. FINAL DX: Intussusception w/obstructive symptoms, s/p difficult air enema reduction. Records faxed to CDC.


VAERS ID: 289959 (history)  
Form: Version 1.0  
Age: 0.2  
Gender: Female  
Location: Washington  
Vaccinated:2007-08-24
Onset:2007-08-29
   Days after vaccination:5
Submitted: 2007-09-06
   Days after onset:8
Entered: 2007-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B129AA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF164AA / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B47300F / 1 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0551U / 1 MO / PO

Administered by: Private       Purchased by: Public
Symptoms: Abdominal X-ray, Enema administration, Faeces discoloured, Intussusception, Irritability, Lethargy, Oral intake reduced, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal obstruction (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Noninfectious diarrhoea (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Pulmonary flow murmur; stenosis nasolacrimal duct
Allergies:
Diagnostic Lab Data: Gastro graffin BE LABS: UGI was WNL. Contrast enema (+) for IS & successfully reduced after 3rd attempt.
CDC Split Type:

Write-up: Symptoms started 8-29-07 with vomiting, decreased oral intake, lethargy, fussiness, intermittent green stools. Intussusception seen on gastrograffin BE and successful reduced. 9/11/07 Received hospital medical records which reveal patient experienced progressively bilious emesis blood tinged stools, decreased oral intake for approx 5 days & then becoming profoundly lethargic on day of admit 8/31-9/1/07. Kept overnight for observation s/p enema reduction of IS. Did well & d/c to home. FINAL DX: Intussusception, enema reduced. 9/11/07 T/C to pcp to request vax record to include lot #s. Unable to print. Verbally confirmed on phone that vax dose & lot #s correct as reported on VAERS form.


VAERS ID: 290179 (history)  
Form: Version 1.0  
Age: 0.2  
Gender: Male  
Location: Unknown  
Vaccinated:2007-05-30
Onset:2007-08-04
   Days after vaccination:66
Submitted: 2007-09-07
   Days after onset:34
Entered: 2007-09-10
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0030U / UNK MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Intussusception, Surgery
SMQs:, Gastrointestinal obstruction (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: None Family HX: patient''s sister & aunt also had IS.
Allergies:
Diagnostic Lab Data: Unknown LABS: multiple KUBs. Abdominal x-ray. Air enema unsuccessful.
CDC Split Type: WAES0708USA05423

Write-up: Information has been received from a health professional concerning a 19 week old male, with no medical history and no allergies, who on 30-MAY-2007 was vaccinated with a dose of Rotateq (Lot# 656385/0030U). On 04-AUG-2007 the patient had surgery for intussusception and was hospitalized. Subsequently, the patient recovered. No product quality complaint was involved. No other information was provided. The patient''s experience was considered to be immediately life-threatening, disabling, and an other important medical event by the reporter. Additional information has been requested. 9/28/07 Received hospital medical records which reveal patient experienced vomiting, irritability, restlessness, abdominal distention & bloody stools x 2 days. Seen in outlying ER & transferred to higher level of care. Admitted 8/4-8/7/2007. IS was nonreducible by air contrast enema & taken to OR for exp lap w/reduction of IS & open appendectomy. Progressed well but continued to have bloody stools throughout hospitalization but lessened w/more formed stools. D/C to home w/pcp & surgical f/u. FINAL DX: Intussusception, surgically reduced.


VAERS ID: 290330 (history)  
Form: Version 1.0  
Age: 0.1  
Gender: Male  
Location: California  
Vaccinated:2007-05-26
Onset:2007-07-15
   Days after vaccination:50
Submitted: 2007-09-05
   Days after onset:52
Entered: 2007-09-12
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B074AA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF022AA / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08674E / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1231F / 1 MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Intussusception, Surgery
SMQs:, Gastrointestinal obstruction (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: LABS: Enema unsuccessful x several attempts.
CDC Split Type:

Write-up: July 2007, intussusception S/P repair. 9/18/07 Reviewed vax record from provider which confirms RO dose & lot # as reported. 9/17/07 Reviewed hospital medical records which reveal patient experienced vomiting. Seen in ER 7/15/07 & d/c to home. Continued w/vomiting, abdominal pain & developed dark stools. Admitted 7/16-7/19/2007. Failed hydrostatic reduction & taken to OR for reduction & appy. Progressed well & d/c to home. FINAL DX: Ileocecal intussusception w/lead point in midtransverse colon; appendectomy.


VAERS ID: 290658 (history)  
Form: Version 1.0  
Age: 0.51  
Gender: Female  
Location: Pennsylvania  
Vaccinated:2007-08-27
Onset:2007-09-04
   Days after vaccination:8
Submitted: 2007-09-14
   Days after onset:10
Entered: 2007-09-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / SANOFI PASTEUR C2657AA / 3 - / -
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 1246F / 3 - / -
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF164AA / 3 - / -
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B47300F / 3 - / -
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0694F / 3 UN / UN

Administered by: Unknown       Purchased by: Unknown
Symptoms: Intussusception
SMQs:, Gastrointestinal obstruction (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown ER LABS: abdominal sonogram WNL. Abdominal x-ray (+) for IS. CXR WNL.
CDC Split Type: WAES0709USA00598

Write-up: Information has been received from a physician concerning a 6 month old female who on 27-AUG-2007 was vaccinated with her third dose of Rotateq. On 04-SEP-2007 the patient had been admitted to a local hospital for a suspected intussusception. On 05-SEP-2007 was sent to a hospital. Medical attention was sought via hospital admission. There was no product quality complaint. No further information is available. 9/18/007 Received patient demographics from CDC. 9/18/07 Received ER medical records which reveal patient experienced abdominal pain, vomiting, bloody diarrahea, lethargy w/palpable mass in left mid abdomen. Had additional bloody diarrhea in ER. Transferred to higher level of care. ER Dx: Intussusception. 9/27/07 Linked w/291340. 10/19/07 Reviewed vaccination record from pcp. VAERS database updated w/same. Records faxed to CDC. 11/2/07 Received hospital medical records which reveal patient experienced bloody stools & fever. Admitted 9/5-9/12/2007. IS not reducible by BE in ER & was taken to surgery for laparoscopic reduction & exp laparotomy. Ileocecectomy performed to remove ischemic segment of cecum. ID consult done. Did well postoperatively & d/c to home FINAL DX: Intussusception, surgically reduced. Records faxed to CDC.


VAERS ID: 290933 (history)  
Form: Version 1.0  
Age: 0.33  
Gender: Female  
Location: Pennsylvania  
Vaccinated:2007-07-12
Onset:2007-09-04
   Days after vaccination:54
Submitted: 2007-09-19
   Days after onset:15
Entered: 2007-09-20
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2655AA / 2 LL / -
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF163AA / 2 LL / -
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0873 / 2 RL / -
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B58845H / 2 LL / -
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0551U / 2 MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Barium enema, Diarrhoea haemorrhagic, Intussusception, Vomiting, X-ray abnormal
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Pseudomembranous colitis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: barium enema X-ray - tx IT
CDC Split Type: WAES0709USA02063

Write-up: Information has been received from a registered nurse concerning a 25-week-old female with no pertinent medical history and no drug reactions/allergies who on 16-MAY-2007 and 12-JUL-2007 was vaccinated PO with the first and second 2mL doses of Rotateq (Lot #''s 656385/0030U and 657292/0551U, respectively). There was no concomitant medication. On 04-SEP-2007 the patient experienced symptoms of intussusception. The patient initially experienced vomiting that was followed by bloody diarrhea 12 hours later. The patient was brought to the emergency room and then transferred to another hospital. The intussusception was treated with a barium enema and the patient was discharged on 05-SEP-2007. On 05-SEP-2007, the patient recovered from intussusception. There were no lab diagnostic studies performed. No further information is available. There was no product quality complaint. The event was considered to be immediately life-threatening and other important medical event by the reporter. Additional information has been requested. 9/28/07 Received hospital x 2 medical records which reveal patient seen in outlying ER for intermittent abdominal pain, vomiting, lethargy, pallor, dehydration & bloody diarrhea. Transferred to higher level of care for successful air contrast enema reduction. Admitted & d/c on 9/5/2007 w/o complication. FINAL DX: Intussusception, enema reduced. 10/5/07 Received vax record. VAERS database updated w/same. Records faxed to CDC.


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