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This is VAERS ID 273097

(NOTE: This result is from the 1/5/2010 version of the VAERS database)

Case Details

VAERS ID: 273097 (history)  
Form: Version .0  
Age: 0.4  
Gender: Unknown  
Location: Unknown  
Vaccinated:2006-10-30
Onset:2006-12-10
   Days after vaccination:41
Submitted: 2007-02-26
   Days after onset:78
Entered: 2007-02-27
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0778F / - - / PO

Administered by: Other       Purchased by: Other
Symptoms: Intussusception
SMQs:, Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: WAES0702USA03466

Write-up: Information has been received from a physician concerning a patient who on approximately 30-OCT-2006 was vaccinated with an oral dose of Rotateq. On 10-DEC-2006 the patient was referred to the hospital for intussusception. The patients outcome was not known. There was no product quality complaint involved. The patient''s intussusception was considered to be life threatening. Additional information has been requested.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20100105&IDNUMBER=273097


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