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This is VAERS ID 305287

Case Details

VAERS ID:305287 (history)  Vaccinated:2008-01-03
Age:  Onset:2008-01-03, Days after vaccination: 0
Gender:Unknown  Submitted:2008-02-14, Days after onset: 42
Location:Tennessee  Entered:2008-02-19, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0801USA00377
Vaccination
Manufacturer
Lot
Dose
Route
Site
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC. 0PO 
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration
SMQs:
Write-up: Information has been received from a registered nurse (RN) concerning a patient who on 03-JAN-2008 was vaccinated with the first dose of Rotateq 25 days later than 12 weeks of age. It was unknown if medical attention was sought. NO adverse symptoms were noted. Additional information has been requested. 02/11/2010 Information has been received from a registered nurse concerning a 16-week-old patient with no known drug alliergies who on 03-JAN-2008 was vaccinatied PO with the first does of GARDASIL (Lot #656379/0505U). Concomitant therapy administered on that same day included the first IM dose in the right leg of (OMPC) (Lot #657174/0497U), the first IM dose in the left leg of PEDIARIX (Lot #AC21B130AA) and the first dose in the right leg of PREVENAR (Lot #6540150). Medical attention was not sought. No adverse symptoms/events were reported. No further information is available.

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