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This is VAERS ID 269099

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

Case Details

VAERS ID: 269099 (history)  
Form: Version .0  
Age:   
Gender: Unknown  
Location: Texas  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2006-12-14
Entered: 2006-12-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS VACCINE, LIVE, ORAL, PENTAVALENT (ROTATEQ) / MERCK & CO. INC. - / 0 - / PO

Administered by: Other       Purchased by: Unknown
Symptoms: Abdominal pain, Intussusception
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), 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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type:

Write-up: Information has been received from a physician concerning a patient who was vaccinated PO with the first dose of ROTATEQ. The physician reported that the patient subsequently developed abdominal cramping. The patient was taken to the Emergency Room (ER),"but it was not known if the patient was hospitalized. The ER physician stated he /"believed this to be a case of intussusception, but made no concrete diagnosis./" The patient''''s symptoms improved and the patient was removed from receiving further doses o


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