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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: 327133 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Female  
Location: Vermont  
Vaccinated:2008-06-25
Onset:2008-09-29
   Days after vaccination:96
Submitted: 2008-10-04
   Days after onset:5
Entered: 2008-10-06
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B142AA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF345AC / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C57538 / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0970U / 1 MO / PO

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

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:
Current Illness: None
Preexisting Conditions: None 9/20/08-records received-Two weeks prior developed upper respiratory infection with runny nose and slight cough.
Allergies:
Diagnostic Lab Data: Air contrast enema - diagnostic + therapeutic 9/20/08-records received- CXR increased density in right middle lobe. Abdominal x-ray normal. 10/28/08-records received-Barium enema reduction with air enema.WBC 21.
CDC Split Type:

Write-up: 9/29/08 Intussusception - reduced with air contrast enema. 10/08/08-records received for DOS 9/20/08-presented with vomiting, lethargy and cough. On day of admission began to vomiting 1-15 times and greenish in color with dark material in it. Diapers not wet, decreased urine output. Not interested in drinking. Weight loss, pale with decreased capillary refill and decreased responsiveness to stimulation and pain. Tachycardic, abdomen distended infrequent bowel sounds.Transferred to another facility. 10/08/08-ED report for DOS 10/8/08-C/O lethargy, pale and bilious forming again. Probably recurrent intussusception. Previously hospitalized for intussusception and lung infection on 9/29/08. 10/28/08-records received from receiving facility for DOS 9/30/08 and 10/8-10/9/08-DC DX: Reduced Intussusception.


VAERS ID: 327332 (history)  
Form: Version 1.0  
Age: 0.5  
Sex: Female  
Location: Florida  
Vaccinated:2008-06-06
Onset:2008-07-12
   Days after vaccination:36
Submitted: 2008-08-13
   Days after onset:32
Entered: 2008-10-07
   Days after submission:55
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B133AA / 3 RL / UN
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF250AD / 3 LL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C57541 / 3 LL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0509U / 3 MO / PO

Administered by: Public       Purchased by: Public
Symptoms: Diarrhoea, Gastroenteritis, Intussusception, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Healthy infant
Allergies:
Diagnostic Lab Data: None LABS: US c/w RUQ IS. BE reduced. Plt count 518(H), neutros 57%(H), bands 7%(H), ANC 10,496(H). Carbod dioxide 17(L). Urine & stool c/s neg.
CDC Split Type:

Write-up: Intussusception - preceded by fever and gastroenteritis with vomiting and diarrhea. ROTATEQ #3 on 6/6/08. 10/17/08 Reviewed hospital medical records of 7/13-7/14/2008. FINAL DX: intussusception, barium enema reduced Records reveal patient experienced vomiting, diarrhea & viral like symptoms. Admitted for overnight observation s/p IS reduction.


VAERS ID: 328692 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Male  
Location: Alabama  
Vaccinated:2008-06-20
Onset:2008-07-18
   Days after vaccination:28
Submitted: 2008-10-15
   Days after onset:89
Entered: 2008-10-16
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B138BA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF333AA / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B70145C / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1243U / 1 MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Abdominal pain upper, Diarrhoea haemorrhagic, Intussusception, Surgery
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? Yes
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Enema administration, 06/18/2008, did not work; surgery 11/11/08-records received- KUB suspicious for intussusception and underwent barium edema demonstrated intussusception, multiple attempts made to reduce were unsuccessful.
CDC Split Type: WAES0810USA01888

Write-up: Information has been received from a physician concerning a 17 week old male who on 20-JUN-2008 was vaccinated PO with the first dose of ROTATEQ. It was reported that on 18-JUL-2008, the patient went back in to the physician''s office with bloody diarrhea and stomach pain. The patient was sent to the emergency room for a work up, and from the results of the work-up the patient was diagnosed with intussusception. The physician at the emergency room tried to give the patient an enema but that "did not work". The patient was hospitalized and had surgery "to clear up the intussusception" (dates not reported). The physician stated the patient recovered (date not reported) and the patient has received the second dose of ROTATEQ (date not reported). The reporter considered intussusception to be an other important medical event, disabling and life-threatening. Additional information has been requested. 11/11/08-records received for DOS 7/20-7/22/08-DC DX: Intussusception. Presented to ED with bloody bowel movement 36 prior to admission. Vomiting throughout the day, became bilious 8 prior to ED visit.PE: distended abdomen with mild tenderness, mass in right lower side and hypoactive bowel sounds. Open reduction of intussusception with appendectomy.


VAERS ID: 328831 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Female  
Location: Ohio  
Vaccinated:2008-09-29
Onset:2008-10-14
   Days after vaccination:15
Submitted: 2008-10-16
   Days after onset:2
Entered: 2008-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B156CA / 2 RL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C71571 / 2 LL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0207X / 2 MO / PO

Administered by: Private       Purchased by: Public
Symptoms: Bowel movement irregularity, Dehydration, Haematochezia, Intussusception, Mucous stools, Urine output decreased, Vomiting
SMQs:, Acute renal failure (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Retroperitoneal fibrosis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Chronic kidney disease (broad), Noninfectious diarrhoea (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (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, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Atb. started by other provider 10/12/08
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: 12/1/08-records received-Ultrasound demonstrated intussusception and reduction with air contrast enema successfully reduced.Pathology report large circular raised lesion shows mucosal ulceration with thick layer necrotic debris and early granulation tissue formation at based. Mesenteric lymph nodes show reactive changes.
CDC Split Type:

Write-up: No BM from 10/11/08, vomiting, decreased diaper wetting, dehydration. Currant jelly stool 10/14. Intussusception -$g hospitalized 10/14/08. Required surgical intervention. Pt. currently admitted to PICU at hospital. 12/1/08-records received for DOS 10/14-//-DC DX: Intussusception. Exploratory laparotomy, reduction of intussusception, small bowel resection incidental appendectomy. Presented with 1 day of emesis. Following morning developed recurrent emesis and repeat ultrasound demonstrated recurrent intussusception and similarly reduced, however patient suffered a respiratory arrest during this procedure. Marked distention of abdomen and lethargy. Surgery demonstrated bowel eviscerated.


VAERS ID: 329010 (history)  
Form: Version 1.0  
Age: 0.5  
Sex: Male  
Location: Illinois  
Vaccinated:2008-10-06
Onset:2008-10-09
   Days after vaccination:3
Submitted: 2008-10-17
   Days after onset:8
Entered: 2008-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (NO BRAND NAME) / SANOFI PASTEUR C3174AA / 1 LL / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U2809AA / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C81640 / 3 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0898X / 3 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Enema administration, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: LABS: WBC 22.7(H), plts 507(H), neutros 73%(H), lymphs 18%(L). US of abdomen (+) IS. Air contrast enema unsuccessful at reducing IS.
CDC Split Type:

Write-up: 3 days after receiving vaccines intussusception was suspected and patient was Hospital were intussusception was diagnosed and was unable to be reduced by enema and had to be done manually in the OR. No bowel resectioning was necessary. 10/28/08 Reviewed hospital medical records of 10/9-10/13/2008. FINAL DX: Intussusception, surgically reduced Records reveal patient experienced intermittent crampy abdominal pain, abdominal distention & vomiting x 3 days. Taken emergently to OR when enema administration did not reduce IS. Open reduction performed. Progressed well & d/c to home.


VAERS ID: 329345 (history)  
Form: Version 1.0  
Age: 0.4  
Sex: Male  
Location: Tennessee  
Vaccinated:2008-10-07
Onset:2008-10-09
   Days after vaccination:2
Submitted: 2008-10-14
   Days after onset:5
Entered: 2008-10-21
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3176AA / 2 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C65931 / 2 RA / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0470X / 2 UN / SC

Administered by: Private       Purchased by: Private
Symptoms: Barium enema, Haematochezia, Intussusception, Irritability, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Ischaemic colitis (broad), Hypoglycaemia (broad)

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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PMH: none. NKDA.
Allergies:
Diagnostic Lab Data: Barium Enema at ER . Labs and Diagnsotics: CBC WNL. KUB (+) for dialted bowel loops. Abd US (+) for IS to hepatic flexure.
CDC Split Type:

Write-up: Irritable, Vomiting, and Blood in stool started 10/9, to ER 10/12. Diagnosed with intusseseption. 10/22/2008 MR received for DOS 10/12-13/2008 with DX: Intussusception. Infant presented to ER with several day hx of vomiting/diarrhea, blood in stool and abdominal pain. Poor PO intake. PE (+) for distended, tender abdomen. R sided abd mass noted by ped surgeon. Dx with IS which was reduced by Barium Enema. Observed o/n.


VAERS ID: 330089 (history)  
Form: Version 1.0  
Age: 0.4  
Sex: Female  
Location: Georgia  
Vaccinated:2008-10-01
Onset:2008-10-12
   Days after vaccination:11
Submitted: 2008-10-24
   Days after onset:12
Entered: 2008-10-27
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. - / UNK UN / UN
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / UNK UN / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0616X / 2 MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Dehydration, Enema administration, Gastroenteritis viral, Haematemesis, Intussusception, Laboratory test, Ultrasound scan abnormal, Vomiting, X-ray
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Dehydration (narrow)

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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Birth Twin
Allergies:
Diagnostic Lab Data: diagnostic laboratory, 10/13/08 , results not reported; X-ray, results not reported; ultrasound, 10/13/08, air reduction: reduced intussusception; urinalysis, results not reported. LABS: stool guiac (+). KUB & US of abdomen. Air enema reduced IS. Urine sp gravity 1.030(H). Blood & urine c/s neg.
CDC Split Type: WAES0810USA04010

Write-up: Information has been received from a physician concerning a 20 week old female with a history of being the second of birth twins born vaginally at 37 weeks gestation who on 07-AUG-2008 and on 01-OCT-2008 was vaccinated PO with the first and second 2.0 ml doses respectively of ROTATEQ (lot #''s for both doses was 660550/0616X). Concomitant therapy included DTAP-IPV-HIB (mfr. unknown) and PREVNAR. On 12-OCT-2008 (late evening), the patient began vomiting. On 13-OCT-2008 (in the morning), the patient was taken to the ER, blood tests (unspecified) were done (results not reported). The patient was diagnosed with a stomach virus and sent home. On 13-OCT-2008 (in the evening) the patient vomited coffee ground blood "matter" and was taken to the ER. The patient was dehydrated and intussusception was diagnosed. The patient had a urine test and an x-ray performed (date and results not reported). The patient was transferred to another health care facility where an air reduction enema ultrasound was performed and was curative. The patient was not hospitalized. The patient was reported as recovered on 14-OCT-2008 and doing fine. The reporter considered the intussusception to be both an other important medical event and life-threatening. A product quality complaint was not involved. A lot check has been requested. Additional information has been requested. 11/11/08 Reviewed ER medical records of 10/13 & 10/14/2008. FINAL DX: viral illness w/fever, vomiting Records reveal patient seen in ER on 10/13 for fever & vomiting, sent to ER by PCP w/concern for possible jaundice. Did well in ER w/o further vomiting. D/C to home. Returned to ER 10/14, FINAL DX: Intussusception, enema reduced At home had continued vomiting, now bilious & coffee grounds; abdominal tenderness, dehydration. Surgery consult done. D/C to home same day & to f/u next day w/PCP.


VAERS ID: 330404 (history)  
Form: Version 1.0  
Age: 0.5  
Sex: Female  
Location: Texas  
Vaccinated:2008-10-20
Onset:2008-10-27
   Days after vaccination:7
Submitted: 2008-10-28
   Days after onset:1
Entered: 2008-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B198AA / 2 LL / -
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF505AB / 2 RL / -
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C25655 / 2 RL / -
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0310X / 1 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Abdominal pain, Barium double contrast, Diarrhoea, Haematochezia, Intussusception, Mucous stools, Rotavirus test positive, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (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:
Other Medications:
Current Illness: unknown, ask PCP
Preexisting Conditions: none. PMH: diarrhea at age 2 months
Allergies:
Diagnostic Lab Data: + rotaviral antigen X 2, + air contrast enema. Labs and Diagnostics: Abd X-ray concerning for IS. Abd US (+) for IS. Air contrast Barium Enema (+) for IS. Rotavirus antigen (+).
CDC Split Type:

Write-up: Pt developed clinical signs of intussuseption (vomiting, colicky abd pain, diarrhea with currant jelly stools (gelatinous blood)) on 10/27/08. She received what appears to be her first dose of RotaTeq 10/20/08 at her PCP''s office. Pt was admitted to Medical Center after transfer from ED. A rotaviral antigen test was positive both at the ED and at Medical Center. Pt had an air contrast enema + for a sectosigmoid intussuseption- it reduced well without surgical intervention. 11/03/2008 MR received for DOS 10/28-29/2008 with D/C DX: Intussusception. Pt presented with 2 day hx of emesis, decreased po intake, flexing legs in pain and diarrhea which turned bloody. IS sucessfully reduced by Air Enema. D/C next day.


VAERS ID: 330559 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Male  
Location: Tennessee  
Vaccinated:2008-10-22
Onset:2008-10-27
   Days after vaccination:5
Submitted: 2008-10-29
   Days after onset:2
Entered: 2008-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B192BA / 2 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF514AA / 2 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C80901 / 2 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0642X / 2 MO / PO

Administered by: Private       Purchased by: Private
Symptoms: Intussusception, Lethargy, 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), Hypoglycaemia (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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: 11/4/08-records received- X-ray RLQ paucity of gas. UGI normal D-J junction. Hydrostatic BE reduction of intussusception with reflux into distal small bowel. WBC 17.1.
CDC Split Type:

Write-up: 10/27/08 - Intussusception - reduced without surgery. Bilious emesis and lethargy. Abd X-ray - suggestive of obstruction. Therapeutic enema reduced intussusception on 10/27/08. 11/4/08-records received for DOS 10/27/08-prsented with C/O lethargy and emesis, yellow tinged emesis, congestion last stool 2 days ago.


VAERS ID: 331202 (history)  
Form: Version 1.0  
Age:   
Sex: Female  
Location: Michigan  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2008-11-03
Entered: 2008-11-04
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 2 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Intussusception, Surgery, Vomiting, X-ray abnormal
SMQs:, Acute pancreatitis (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? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: X-ray, ?/?/07, diagnosed intussusception; surgery, ?/?/07, to correct the intussusception
CDC Split Type: WAES0810USA04956

Write-up: Information has been received from an office manager concerning a female baby who on an unspecified date in 2007 was vaccinated with the second dose of ROTATEQ. The office manager reported that in 2007 the patient was seen in the office for severe vomiting and was sent to the emergency room. An x-ray was taken and the patient was diagnosed with intussusception. The patient had surgery. The outcome was reported as recovered (date not reported). Upon internal review intussusception was considered to be an other important medical event. This is one of two reports from the same source. Additional information has been requested.


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