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This is VAERS ID 273461

Case Details

VAERS ID: 273461 (history)  
Form: Version 1.0  
Age: 0.58  
Sex: Female  
Location: California  
   Days after vaccination:35
Submitted: 2007-03-05
   Days after onset:13
Entered: 2007-03-06
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Barium double contrast, Intussusception
SMQs:, Gastrointestinal obstruction (narrow)

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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: UNK
CDC Split Type: WAES0702USA04062

Write-up: Information has been received from a physician concerning a 7 month old female, with no medical history, who was vaccinated with an oral first, second, and third dose of Rotateq, on 19-SEP-2006, 20-NOV-2006, and 16-JAN-2007, respectively. There was no concomitant medication. On 20-FEB-2007, the patient developed intussusception and was admitted to the hospital the morning of 21-FEB-2007. The patient was given an air enema three times before the condition responded. It was reported that the patient would be released from the hospital on 22-FEB-2007. At the time of the report the patient was recovering. No product quality complaint was involved. No other information was provided. The patient''s experience was considered to be an other important medical event, immediately life-threatening, and disabling by the reporter. Additional information has been requested.

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