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This is VAERS ID 282368

(NOTE: This result is from the 9/14/2017 version of the VAERS database)

Case Details

VAERS ID: 282368 (history)  
Form: Version 1.0  
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 - / UNK UN / UN
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / UNK UN / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0577F / 3 MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Anorexia, Barium double contrast, Barium enema, Diarrhoea, Gastrointestinal disorder, Intussusception, Irritability, Vomiting, X-ray
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal obstruction (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)

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: WAES0706USA02578

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 vaccine. 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 vomiting and had diarrhea and was taken to the pediactrics'' office the next day and the physician checked him and sent him home. On 06-JUN-2007, the patient was still vomiting and had diarrhea and was again taken to the ER and was admitted with a diagnosis of "intussusception", he had an ''air contrast enema" done twice and "it helped him". The patient was discharged 24 hours later on 07-JUN-2007. The patient''s outcome was reported as recovered. The physician considered intussusception to be an other important medical event. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20170914&IDNUMBER=282368


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