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This is VAERS ID 284182

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

Case Details

VAERS ID: 284182 (history)  
Form: Version .0  
Age:   
Gender: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2007-07-09
Entered: 2007-07-10
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 2 - / PO

Administered by: Other       Purchased by: Unknown
Symptoms: Intussusception
SMQs:, Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Information has been received from a physician concerning a patient who was vaccinated with the third dose of Rotateq. Subsequently after receiving the third dose of Rotateq, the patient /"came down with intussusception/". Upon internal review intussuscep"tion was determined to be an other important medical event. Additional information has been requested.


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Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20071231&IDNUMBER=284182


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