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This is VAERS ID 285492

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

Case Details

VAERS ID: 285492 (history)  
Form: Version .0  
Age: 0.6  
Gender: Female  
Location: Texas  
Vaccinated:2007-03-15
Onset:2007-06-10
   Days after vaccination:87
Submitted: 2007-07-20
   Days after onset:40
Entered: 2007-07-23
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (FLUZONE) / SANOFI PASTEUR 62283AA / 5 RA / -
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1113F / 2 - / PO

Administered by: Other       Purchased by: Unknown
Symptoms: Appendicectomy, Barium enema, Explorative laparotomy, Intussusception, Rectal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Information has been received from a office manager in a physician''''s office concerning a 10 month old female, with no allergies, no history of surgery, no prior history of intussusception, congenital malformation of the intestine, or cystic fibrosis, who"was vaccinated with a first, second, and third dose of Rotateq on 18-JAN-2007 (Lot# 653980/0285F), 15-FEB-2007 (Lot# 654489/0941F), and 15-MAR-2007 (Lot# 655405/1113F), respectively. It was reported that the office received an operative report stating tha


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20071231&IDNUMBER=285492


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