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This is VAERS ID 333345

Case Details

VAERS ID: 333345 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Female  
Location: Michigan  
Vaccinated:2008-06-01
Onset:2008-06-01
   Days after vaccination:0
Submitted: 2008-11-25
   Days after onset:177
Entered: 2008-11-26
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 2 MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Haematochezia, Intussusception, Irritability
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Ischaemic colitis (broad), Hypoglycaemia (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, 0 days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0811USA03530

Write-up: Information has been received from a physician concerning a 16 week old female patient, who this summer of 2008 was vaccinated orally with the second dose of ROTATEQ, and within a week experienced irritability and had a blood on the stool. The patient was brought in the emergency room and was hospitalized. Patient was diagnosed of intussusception. The patient possibly underwent an ultrasound. Subsequently, the patient recovered. No further information is available.


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