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This is VAERS ID 282368

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

Case Details

VAERS ID: 282368 (history)  
Form: Version .0  
Age: 0.5  
Gender: Male  
Location: Unknown  
Vaccinated:2007-06-05
Onset:2007-06-05
   Days after vaccination:0
Submitted: 2007-06-19
   Days after onset:14
Entered: 2007-06-20
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / - UN / UN
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0577F / 2 - / PO

Administered by: Other       Purchased by: Unknown
Symptoms: Anorexia, Barium double contrast, Barium enema, Diarrhoea, Gastrointestinal disorder
SMQs:, Pseudomembranous colitis (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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Barium enema X-ray 06/06/07 - air contrast enema x 2
CDC Split Type:

Write-up: Information has been received from a physician concerning a 6 month old male who on approximately 05-JUN-2007 was vaccinated with third dose of Rotateq (LOT# 654248/0577F). Concomitant vaccines included DTaP (also reported as /"Betap/") and poliovirus vac"cine. On 05-JUN-2007, the physician reported that the patient experienced /"fussiness and wasn''''t eating/". The parents took him to the emergency room (ER) and he was released with a diagnoses of /"some gastrointestinal problems/". The patient was also vo


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