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This is VAERS ID 292245

Case Details

VAERS ID: 292245 (history)  
Form: Version 1.0  
Age: 0.5  
Gender: Unknown  
Location: Maryland  
Vaccinated:0000-00-00
Onset:2006-09-01
Submitted: 2007-10-04
   Days after onset:398
Entered: 2007-10-05
   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? 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: WAES0710USA00147

Write-up: Information has been received from a physician concerning a 6 month old patient who was vaccinated with a dose of Rotateq. In approximately September 2006 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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