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This is VAERS ID 305679

(NOTE: This result is from the 6/14/2014 version of the VAERS database)

Case Details

VAERS ID: 305679 (history)  
Form: Version .0  
Age: 0.2  
Gender: Female  
Location: Maryland  
   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

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)

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:
Current Illness:
Preexisting Conditions: Gastrooesophageal reflux
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. 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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