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This is VAERS ID 273703

Case Details

VAERS ID: 273703 (history)  
Form: Version 1.0  
Age: 0.52  
Sex: Female  
Location: Alabama  
   Days after vaccination:99
Submitted: 2007-03-08
   Days after onset:15
Entered: 2007-03-09
   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? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0703USA00661

Write-up: Information has been received from a physician concerning a 9 month old white female patient who was vaccinated with a first, second and third oral dose of Rotateq on 01-JUL-2006 (Lot # 653754/0139F), 11-SEP-2006 (Lot # 654248/0577F), and 14-NOV-2006 (Lot# 654248/0577F). Medical history and drug allergies were reported as unknown. Concomitant therapy was unknown. On 21-FEB-2007 the patient was diagnosed with intussusception. Patient was admitted to hospital on 21-FEB-2007. The patient underwent 2 air enemas and the intussusception reversed. On 22-FEB-2007, the patient was discharged from the hospital. Outcome reported as recovered. there was no product quality complaint involved. Additional information has been requested.

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