National Vaccine
Information Center

Your Health. Your Family. Your Choice.
Search Results

From the 1/7/2022 release of VAERS data:

This is VAERS ID 266013

Government Disclaimer on use of this data

Case Details

VAERS ID: 266013 (history)  
Form: Version 1.0  
Age: 0.6  
Sex: Male  
Location: Kansas  
   Days after vaccination:38
Submitted: 2006-11-03
   Days after onset:12
Entered: 2006-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Abdominal pain, Appendicectomy, Chest X-ray, Dehydration, Haematemesis, Haematochezia, Intestinal resection, Intussusception, Lethargy, Lymphadenopathy, Nausea, Pyrexia, White blood cell count
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zyrtec; Zantac
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: LABS: CXR showed some minimal atelectasis of LLL. WBC 10.4, segs 50, lymps 39, 0 bands
CDC Split Type: WAES0611USA00634

Write-up: Information has been received from a consumer concerning her 8 month old son, with no medical history and no allergies, who was vaccinated with a first and second oral dose of rotavirus G1 G2 G3 G4 P1 reassortant vaccine live on 8/15/06 and 9/14/06, respectively. Concomitant therapy included ranitidine HCl and cetirizine hydrochloride. it was reported that on the evening of 10/22/06 the patient was lethargic, had blood in his stool, was vomiting with dried black blood, and was dehydrated. A physician diagnosed the patient with intussusception that was about 8mm in length on the morning of 10/23/06 and was hospitalized. It was reported that the patient had to have emergency surgery for a bowel resection. The reporter noted that the surgeon indicated that the patient also had a swollen lymph node about the size of a shooter marble and he believed that it may have been related to the experience. At the time of the report, it was noted that the patient was doing much better. The patient''s experience was considered to be immediately life-threatening and disabling by the reporter. Additional information has been requested. 11/27/06 Received medical records from hospital which reveal patient admitted 10/23/06 with nausea, vomiting & colicky symptoms. Barium enema did not reduce IS & patient taken to surgery for reduction of IS with ileocecal resection & appendectomy. Continued to improve w/o further complication & was d/c to home on 10/27/06. PMH: GERD, URIs Final Dx: Intussusception (IS) and chronic reflux. Patient was readmitted for overnight observation & hydration on 10/28-10/29/06 after running a fever of 102 for approx 1 day. It was felt to be a viral infection./ss

New Search

Link To This Search Result:

Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166