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This is VAERS ID 270003

(NOTE: This result is from the 12/31/2007 version of the VAERS database)

Case Details

VAERS ID: 270003 (history)  
Form: Version .0  
Age: 0.2  
Gender: Male  
Location: Texas  
   Days after vaccination:53
Submitted: 2006-12-21
   Days after onset:33
Entered: 2007-01-03
   Days after submission:13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: Unknown
Symptoms: Barium double contrast, Decreased appetite, Diarrhoea haemorrhagic, Gastroenteritis, Hypertension
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad), Hypertension (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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: LABS: US of abdomen revealed RLQ IS. Air contrast enema x 2. Renal US was WNL.
CDC Split Type:

Write-up: Information has been received from a physician concerning a 2-month-old male who was vaccinated with the first dose of rotavirus G1 G2 G3 G4 P1 reassortant vaccine live (human-bovine). The physician reported that the patient developed intussusception with"in /"a month of getting vaccinated/". Unspecified medical attention was sought. Subsequently, the patient recovered. It was noted that the patient would not be vaccinated with the second or third dose. Upon internal review, intussusception was determined

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