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This is VAERS ID 305679

Case Details

VAERS ID:305679 (history)  Vaccinated:2008-01-25
Age:0.2  Onset:2008-01-25, Days after vaccination: 0
Gender:Female  Submitted:2008-02-14, Days after onset: 20
Location:Maryland  Entered:2008-02-19, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Gastrooesophageal reflux
Diagnostic Lab Data: unknown
CDC 'Split Type': WAES0801USA05806
Vaccination
Manufacturer
Lot
Dose
Route
Site
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.0904U0PO 
Administered by: Other     Purchased by: Other
Symptoms: Immediate post-injection reaction, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up: Information has been received from a physician concerning a 9 week old female with gastrooesophageal reflux who on 25-JAN-2008 was vaccinated PO with her first 2.0 ml dose of ROTATEQ (lot# 657673/0904U) and vomited immediately after. Medical attention was sought via physician''s office. The outcome was unknown. There was no product quality complaint. Additional information has been requested. 02/11/2010 Follow-up information from the reporting physician concerning a 9 week old female who on 23-JAN-2008 was vaccinated PO with her first dose of GARDASIL (lot# 657673/0904U). There was to illness at the time vaccination. Concomitant vaccinations administered on that same day included the first IM dose of PEVENAR (lot#041339), the first IM dose of RECOMBIVAX HB and (DAPTACEL) (lot# C2933AB) and first IM dose of (IPOL) (lot# A047U). Immediately after the dose of GARDASIL (lot # 657673/0904U) the patient vomited and subsequently removed immediately after immediately after dose. Additional information has been requested.

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