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This is VAERS ID 274365

(NOTE: This result is from the 5/13/2013 version of the VAERS database)

Case Details

VAERS ID: 274365 (history)  
Form: Version .0  
Sex: Female  
Location: Unknown  
Submitted: 2007-03-19
Entered: 2007-03-20
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Barium enema, Intussusception, X-ray
SMQs:, Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad)

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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: barium enema X-ray
CDC Split Type: WAES0703USA01323

Write-up: Information has been received from a retired physician concerning his granddaughter who was vaccinated with a 2 ml oral dose of Rotateq. Subsequently the patient was treated for intussusception. It was reported that a barium enema was performed. At the time of the report the patient was recovering. No product quality complaint was involved. No other information was provided. Upon internal review, the patient''s intussusception was considered to be an other important medical event. Additional information is not expected.

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