National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 267879

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

Case Details

VAERS ID: 267879 (history)  
Form: Version .0  
Age: 0.2  
Gender: Male  
Location: Texas  
Vaccinated:2006-11-03
Onset:2006-11-24
   Days after vaccination:21
Submitted: 2006-11-28
   Days after onset:4
Entered: 2006-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2490AA / 0 LL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0681F / 0 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0420 / 0 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08666H / 0 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0979F / 0 LL / IM

Administered by: Private       Purchased by: Private
Symptoms: Crying, Haematochezia, Intestinal resection, Intussusception, Surgery
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad), Depression (excl suicide and self injury) (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: NONE
Current Illness:
Preexisting Conditions: Mild atopic dermatitis.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt visiting out of country with parents began with persistent crying on 11/25/06. On 11/26/06 awoke with diaper of blood. Diagnosed with intussusception and had partial small bowel resection performed emergency out of country. Unable to assess now. Per 60 day follow up: Currently recovered, however, he did have to have bowel resected so potentially problems later with absorption.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20130513&IDNUMBER=267879


Copyright © 2018 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166