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This is VAERS ID 292242

Case Details

VAERS ID: 292242 (history)  
Form: Version 1.0  
Age: 1.0  
Gender: Unknown  
Location: Maryland  
Vaccinated:0000-00-00
Onset:2007-03-01
Submitted: 2007-10-04
   Days after onset:216
Entered: 2007-10-05
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 3 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, Intussusception
SMQs:, Gastrointestinal obstruction (narrow), Medication errors (narrow)

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? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0709USA04715

Write-up: Information has been received from a physician concerning a 1 year old patient who was vaccinated with three doses of Rotateq. In approximately March 2007, the patient developed intussusception. Medical attention was sought in the physician''s office. The outcome was unknown at the time of this report. There was no product quality complaint. Upon internal review, intussusception was determined to be an other important medical event. This is one of several reports from the same source. No further information is available.


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