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This is VAERS ID 311257

Case Details

VAERS ID: 311257 (history)  
Form: Version 1.0  
Age: 0.4  
Gender: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2008-04-29
Entered: 2008-04-30
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 1 MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Intussusception, Laboratory test abnormal, Mucous stools, Surgery, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: diagnostic laboratory, positive currant jelly stool; diagnostic laboratory, intussusception
CDC Split Type: WAES0804USA05251

Write-up: Information has been received from a Post-Marketing evaluation program for Rotateq concerning a 5 month old male who was vaccinated PO with her first dose of Rotateq. Subsequently 36 days post dose, the patient was admitted to the hospital with a 3 day history of intractable vomiting and no diarrhea and remained hospitalized for 6 days. Films were performed which showed a positive result for currant jelly stool and intussusception requiring resection. The patient recovered and was discharged on day 6. Intussusception was also considered to be an other important medical event by the reporter. Additional information has been requested.


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