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This is VAERS ID 286490

Case Details

VAERS ID: 286490 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Kentucky  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2007-08-01
Entered: 2007-08-02
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Intussusception
SMQs:, Gastrointestinal obstruction (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, 0 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0707USA04032

Write-up: Information has been received from a physician concerning a female patient who was vaccinated with a dose of Rotateq. Subsequently "after the fourth month dose" the patient experienced intussusception and was hospitalized. It was reported that the patient was in the hospital but the length of stay was not provided. On an unspecified ate, the patient recovered. No product quality complaint was involved. Additional information has been requested.


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