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This is VAERS ID 304208

Case Details

VAERS ID: 304208 (history)  
Form: Version 1.0  
Age: 0.3  
Gender: Female  
Location: Texas  
Submitted: 2008-02-01
Entered: 2008-02-04
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Abdominal pain, Barium enema, Diarrhoea, Intussusception, Surgery
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (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? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0801USA05730

Write-up: Information has been received from a physician concerning an 18 week old female (also reported as 5 months old and also reported as 2 weeks after the patient was 4 months old) who was vaccinated with Rotateq. It was reported the vaccinations with Rotateq started when the patient was 2 months of age and that the patient received other vaccinations at 4 months of age. The physician reported that the patient received her second dose of Rotateq and within two weeks of getting it, she experienced "severe abdominal cramps and diarrhea". Onset date was reported as 2 weeks after the patient was 4 weeks old. The patient''s mother took her straight to the emergency room where the patient was given a barium enema which did not work. The patient was diagnosed with intussusception which had to be surgically reduced. It was unknown if the patient was hospitalized. Subsequently (on an unspecified date), the patient recovered from intussusception. There was no product quality complaint. Intussusception was considered to be an other important medical event. Additional information has been requested.

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