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This is VAERS ID 268405

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

Case Details

VAERS ID: 268405 (history)  
Form: Version .0  
Age: 0.4  
Gender: Female  
Location: South Carolina  
Vaccinated:2006-11-27
Onset:2006-11-29
   Days after vaccination:2
Submitted: 2006-12-04
   Days after onset:5
Entered: 2006-12-06
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (UNKNOWN MFR) / UNKNOWN MANUFACTURER - / - UN / -
HIBV: HIB (UNKNOWN MFR) / UNKNOWN MANUFACTURER - / - UN / -
IPV: POLIO VIRUS, INACT. (IPOL) / AVENTIS PASTEUR, INC. - / - UN / -
PNC: PNEUMO, 7-VALENT (PREVNAR) / LEDERLE LABORATORIES - / - UN / -
ROTHB5: ROTAVIRUS VACCINE, LIVE, ORAL, PENTAVALENT (ROTATEQ) / MERCK & CO. INC. 1034F / - - / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Intestinal gangrene, Intestinal obstruction, Intussusception, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal obstruction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 2 days after Rotateq, patient began vomiting 11/29/06 ultrasound on 12/1/06 showed signs of obstruction and . Abdomen-surgery on 12/1/06 revealed intussusception with gangrenous ascending and transverse colon-after, colectomy of involved segment Andre-an"astomosis. Patient is doing well.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20061230&IDNUMBER=268405


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