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This is VAERS ID 274077

(NOTE: This result is from the 12/8/2009 version of the VAERS database)

Case Details

VAERS ID: 274077 (history)  
Form: Version .0  
Age:   
Gender: Unknown  
Location: Alabama  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2007-03-15
Entered: 2007-03-16
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 0 - / PO

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
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: WAES0703USA00908

Write-up: Information has been requested from a physician concerning a patient who was vaccinated with a first oral 2 ml dose of Rotateq. Subsequently the patient developed intussusception. Medical attention was not sought. No product quality complaint was involved. No other information was provided. Upon internal review, the patient''s intussusception was considered to be an other important medical event. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20091208&IDNUMBER=274077


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