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This is VAERS ID 284182

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

Case Details

VAERS ID: 284182 (history)  
Form: Version 1.0  
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
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 3 MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Intussusception
SMQs:, Gastrointestinal obstruction (narrow)

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: WAES0707USA00566

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 intussusception was determined 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=284182


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