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This is VAERS ID 274364

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

Case Details

VAERS ID: 274364 (history)  
Form: Version .0  
Age: 0.3  
Gender: Female  
Location: North Carolina  
   Days after vaccination:64
Submitted: 2007-03-19
   Days after onset:15
Entered: 2007-03-20
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Unknown
Symptoms: Appendicectomy, Barium enema, Culture urine negative, Haematochezia, Intussusception
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type:

Write-up: Information has been received from a physician concerning a 6 month old Middle Eastern female who was vaccinated with a first and second dose of Rotavirus on 27-OCT-2006 and 29-DEC-2006, respectively. On 03-MAR-2007 the patient was hospitalized for intuss"usception, which required surgery, but no bowel resection. Subsequently, the patient recovered. No other information was provided. Additional information has been requested.

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