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This is VAERS ID 284183

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

Case Details

VAERS ID: 284183 (history)  
Form: Version .0  
Age: 0.2  
Gender: Female  
Location: Unknown  
Vaccinated:2007-05-15
Onset:2007-05-22
   Days after vaccination:7
Submitted: 2007-07-09
   Days after onset:48
Entered: 2007-07-10
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2628M / 0 LL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 1416F / 0 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0922 / 0 LL / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC B0876920 / 0 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0235N / 0 - / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Abdominal mass, Abnormal faeces, Barium enema, Blood culture negative, Culture stool negative
SMQs:, Biliary system related investigations, signs and symptoms (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, 2 days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown. PMH:none.
Allergies:
Diagnostic Lab Data: Unknown. Labs and Diagnostics: KUB showed distended small and large bowel loops. Barium enema done-intussusception identified and reduced. Repeat US was done post reduction with no evidence of recurrent IS. Labs and Diagnsotics: KUB 5/2
CDC Split Type:

Write-up: Information has been received from a physician concerning a female who was vaccinated with Rotateq PO 2nd dose. Concomitant therapy included /"other vaccines at the same time./" Subsequently the patient developed an intussusception and was hospitalized. T"he physician reported that the intussusception was reduced with a barium enema and no surgery was needed. The physician reported that the patient recovered on an unspecified date. The physician reported that intussusception required intervention to preven


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