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This is VAERS ID 305679

(NOTE: This result is from the 12/8/2009 version of the VAERS database)

Case Details

VAERS ID: 305679 (history)  
Form: Version .0  
Age: 0.2  
Gender: Female  
Location: Maryland  
Vaccinated:2008-01-25
Onset:2008-01-25
   Days after vaccination:0
Submitted: 2008-02-14
   Days after onset:20
Entered: 2008-02-19
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0904U / 0 - / PO

Administered by: Other       Purchased by: Other
Symptoms: Immediate post-injection reaction, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Gastrooesophageal reflux
Allergies:
Diagnostic Lab Data: unknown
CDC Split Type: WAES0801USA05806

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.


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http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20091208&IDNUMBER=305679


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