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This is VAERS ID 289033

(NOTE: This result is from the 12/31/2007 version of the VAERS database)

Case Details

VAERS ID: 289033 (history)  
Form: Version .0  
Age: 0.5  
Sex: Female  
Location: Maryland  
Vaccinated:2007-07-16
Onset:2007-08-14
   Days after vaccination:29
Submitted: 2007-08-24
   Days after onset:10
Entered: 2007-08-27
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / - - / PO

Administered by: Other       Purchased by: Unknown
Symptoms: Diarrhoea haemorrhagic, Intussusception, Pyrexia, Surgery, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Information has been received from a a physician concerning a 7 month old female with no drug allergies who on 16-JUL-2007 was vaccinated with a 2ml oral dose of Rotateq. On 14-AUG-2007 the patient developed intussusception characterized by vomiting, low"grade fever, and bloody diarrhea. Medical attention was sought via emergency room visit and the patient was hospitalized. Numerous tests (unspecified), confirmed a diagnosis of intussusception and a partial iliac resection was performed. Subsequently the


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20071231&IDNUMBER=289033


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