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This is VAERS ID 285151

Case Details

VAERS ID: 285151 (history)  
Form: Version 1.0  
Age: 0.4  
Gender: Female  
Location: Unknown  
Vaccinated:2007-03-20
Onset:2007-05-21
   Days after vaccination:62
Submitted: 2007-07-18
   Days after onset:58
Entered: 2007-07-19
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR U1965CA / 2 RL / -
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1124F / 2 RL / -
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Y1032 / 2 LL / -
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08670D / 2 LL / -
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0779F / 2 MO / PO

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown 10/12/07-records received-Contrast enema revealed presence of intussusception which could not be reduced hypostatically. Pneumatic reduction also unsuccessful.
CDC Split Type: WAES0707USA01897

Write-up: Information has been received from a physician''s assistant concerning a patient who was vaccinated PO with a dose of Rotateq. Subsequently the patient experienced intussusception and was hospitalized. Surgery was required. The patient recovered. No additional information was available. Intussusception was considered to be immediately life-threatening by the reporter. Additional information has been requested. 10/12/07-records received for DOS 5/23-5/29/07- DC DX: Intussusception. Open reduction with decompressive enterotomy and appendectomy. Presented with 2 day history of vomiting and alternating lethargy and crying. Post operative ileus


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