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This is VAERS ID 278136

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

Case Details

VAERS ID: 278136 (history)  
Form: Version .0  
Age: 0.2  
Gender: Female  
Location: New Mexico  
   Days after vaccination:3
Submitted: 2007-05-07
   Days after onset:16
Entered: 2007-05-08
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Unknown
Symptoms: Abdominal X-ray, Abdominal distension, Abdominal pain, Abdominal tenderness, Appendicectomy
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None. PMH: none. NKDA.
Diagnostic Lab Data: Unknown. Labs and Diagnostics: Abd X-ray revealed multiple dilated loops of bowel in mid-abdomen. ? Volvulus vs. intussusception. Barium enema (+) for intussusception.
CDC Split Type:

Write-up: Information has been received from a registered nurse concerning a 10 week old formula fed female with no medical history or allergies who on 18-APR-2007 was vaccinated with a 2 ml oral dose of Rotateq (lot # 656196/0026U). There was no concomitant medica"tion. On 21-APR-2007 the patient developed vomiting. She was seen in the ER that day. She was admitted to the hospital with intussusception. Barium procedure to open the bowel was unsuccessful. Surgery was required. On 23-APR-2007 the baby was discharged

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