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This is VAERS ID 280241

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

Case Details

VAERS ID: 280241 (history)  
Form: Version .0  
Age: 0.4  
Gender: Male  
Location: California  
   Days after vaccination:40
Submitted: 2007-06-01
   Days after onset:34
Entered: 2007-06-04
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Unknown
Symptoms: Abdominal pain, Appendicectomy, Chest X-ray, Full blood count
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: TYLENOL
Current Illness:
Preexisting Conditions: None PMH: GERD PMH: recurrent URI
Diagnostic Lab Data: Unknown LABS: CXR, KUB, CBC, chemistries, UA, RSV, influenza A&B. Barium contrast SB follow through revealed possible malrotation.
CDC Split Type:

Write-up: Information has been received from a certified medical assistant concerning a 6 month old male, with no medical history and no allergies, who was vaccinated with a first and second 2 ml oral dose of Rotateq (Lot# 654422/0607F and 656187/1237F) on 16-JAN-2"007 and 19-MAR-2007, respectively. Concomitant therapy included Tylenol as needed. On 28-APR-2007 the patient was taken to the emergency room and was transported to another facility that was equipped to handle children. The patient was hospitalized and un

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