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This is VAERS ID 309574

Case Details

VAERS ID: 309574 (history)  
Form: Version 1.0  
Age: 0.5  
Sex: Female  
Location: Unknown  
Submitted: 2008-04-15
   Days after onset:11
Entered: 2008-04-16
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Intussusception, Vomiting projectile
SMQs:, Acute pancreatitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal obstruction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad)

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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0804USA01492

Write-up: Information has been received from a nurse practitioner concerning her 6-month-old granddaughter with no pertinent medical history and no drug reactions/allergies who was vaccinated PO with the second dose of Rotateq. There was no concomitant medication. Subsequently, three weeks post vaccination, the patient experienced projectile vomiting and intussusception and was hospitalized. She was hospitalized for 2 days. On approximately 04-APR-2008, the patient developed "similar symptoms" but has not required hospitalization and has not been diagnosed with intussusception. No additional information is available. There was no product quality complaint. Additional information has been requested.

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