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This is VAERS ID 279891

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

Case Details

VAERS ID: 279891 (history)  
Form: Version .0  
Age: 0.3  
Gender: Female  
Location: Texas  
Vaccinated:2007-03-02
Onset:2007-04-26
   Days after vaccination:55
Submitted: 2007-05-25
   Days after onset:29
Entered: 2007-05-29
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1238F / 1 - / PO

Administered by: Other       Purchased by: Unknown
Symptoms: Abdominal rigidity, Abdominal tenderness, Bacteria urine, Barium double contrast, Eyes sunken
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Information has been received from a physician concerning a 6 month old female, with no medical history and no allergies, who was vaccinated with a first, second, and third oral dose of Rotateq (Lot# /"1116D,/" 656188/1238F, and 656194/0024U) on 17-JAN-20"07, 02-MAR-2007, and 15-MAY-2007, respectively. There was no concomitant medication. On 26-APR-2007 the patient was treated at the emergency room for intussusception and then released. No other symptoms were noted. Subsequently, the patient recovered. No


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