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This is VAERS ID 274937

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

Case Details

VAERS ID: 274937 (history)  
Form: Version .0  
Age: 0.5  
Gender: Female  
Location: Unknown  
   Days after vaccination:27
Submitted: 2007-03-26
   Days after onset:26
Entered: 2007-03-27
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Unknown
Symptoms: Abdominal X-ray, Abdominal rigidity, Anion gap increased, Barium enema, Blood calcium increased
SMQs:, Acute pancreatitis (broad), Lactic acidosis (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? Yes
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 female who on 31-JAN-2007 was vaccinated with her last dose of Rotateq (lot #654970/0777F) (the dated of the other two doses were not reported). The patient had no medical history or"concomitant therapy. On 27-FEB-2007, the patient was examined by the physician and had developed intussusception. The patient''''s symptoms at the time of the exam were reported as unknown. On 01-MAR-2007, the patient was hospitalized for intussusception. A

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