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This is VAERS ID 285684

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

Case Details

VAERS ID: 285684 (history)  
Form: Version .0  
Age: 0.5  
Gender: Female  
Location: Unknown  
Vaccinated:2007-05-30
Onset:2007-06-28
   Days after vaccination:29
Submitted: 2007-07-23
   Days after onset:25
Entered: 2007-07-24
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER C2605AA / 1 LL / UN
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER UF08711 / 1 RL / UN
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0547 / 1 LL / UN
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0025U / 2 - / PO

Administered by: Other       Purchased by: Unknown
Symptoms: Abdominal X-ray, Blood sodium increased, Diarrhoea, Diarrhoea haemorrhagic, Intussusception
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: physical examination
CDC Split Type:

Write-up: Information has been received from a physician concerning a 7 month old female who was vaccinated with third 2 ml oral dose of Rotateq. Concomitant vaccinations given at the same time included DTaP, Hib and IPV. Subsequently, the patient experienced intus"susception and was hospitalized (length of stay unspecified). A physical examination was performed results not provided. Intussusception was considered to be immediately life-threatening and an other important medical event which required surgery. Additio


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