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This is VAERS ID 266013

(NOTE: This result is from the 12/30/2006 version of the VAERS database)

Case Details

VAERS ID: 266013 (history)  
Form: Version .0  
Age: 0.6  
Gender: Male  
Location: Kansas  
Vaccinated:2006-09-14
Onset:2006-10-22
   Days after vaccination:38
Submitted: 2006-11-03
   Days after onset:12
Entered: 2006-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS VACCINE, LIVE, ORAL, PENTAVALENT (ROTATEQ) / MERCK & CO. INC. - / 1 - / PO

Administered by: Other       Purchased by: Unknown
Symptoms: Abdominal pain, Dehydration, Haematemesis, Haematochezia, Intussusception
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zyrtec; Zantac
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: LABS: CXR showed some minimal atelectasis of LLL. WBC 10.4, segs 50, lymps 39, 0 bands
CDC Split Type:

Write-up: Information has been received from a consumer concerning her 8 month old son, with no medical history and no allergies, who was vaccinated with a first and second oral dose of rotavirus G1 G2 G3 G4 P1 reassortant vaccine live on 8/15/06 and 9/14/06, respe"ctively. Concomitant therapy included ranitidine HCl and cetirizine hydrochloride. it was reported that on the evening of 10/22/06 the patient was lethargic, had blood in his stool, was vomiting with dried black blood, and was dehydrated. A physician diag


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