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This is VAERS ID 332858

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

Case Details

VAERS ID: 332858 (history)  
Form: Version .0  
Age: 0.2  
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2008-11-19
Entered: 2008-11-20
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 0 - / PO

Administered by: Other       Purchased by: Other
Symptoms: Abdominal pain, Enema administration, Haematochezia, Intussusception
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (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? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: enema administration, 07?, air enema: revealed ileocolic intussusception, was reduced
CDC Split Type: WAES0811USA02517

Write-up: Information has been received from a health professional concerning an 8 week old male who was entered in a study. In approximately 2007, the patient was vaccinated PO with the first dose of ROTATEQ. It was reported that 21 days post-vaccination, the patient presented with dark bloody stools and crampy abdominal pain. The patient was hospitalized and referred for a surgical evaluation to rule out intussusception. An air enema revealed an ileocolic intussusception which was reduced. The patient was discharged "well" on "day 2". The reporting investigator considered intussusception to be an other important medical event. No further information is available.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20130513&IDNUMBER=332858


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