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This is VAERS ID 300550

Case Details

VAERS ID: 300550 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2007-12-19
Entered: 2007-12-20
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 3 MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Barium enema, Intussusception
SMQs:, Gastrointestinal obstruction (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0712USA03809

Write-up: Information has been received from a physician concerning a female who began the vaccination series at "2 months of age" (date not reported) with Rotateq. It was reported that one month after receiving the third dose of the vaccine (date not reported) she developed intussusception and was hospitalized. Diagnostics were not reported. The intussusception was treated with a barium enema. At the time of this report, it was reported that the patient had recovered. Intussusception was considered to be life threatening and an other important medical event by the reporter. Additional information has been requested.


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