National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 268134

Case Details

VAERS ID: 268134 (history)  
Form: Version 1.0  
Age: 0.17  
Gender: Female  
Location: California  
Vaccinated:2006-11-14
Onset:2006-11-29
   Days after vaccination:15
Submitted: 2006-12-01
   Days after onset:2
Entered: 2006-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2650AA / 1 LL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0679F / 1 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR 41031 / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08689D / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0848F / 1 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Anaemia, Haematochezia, Intussusception, Listless, Oral intake reduced, Pallor
SMQs:, Haematopoietic erythropenia (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Ischaemic colitis (broad), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: Records available. Anemia reported by parents.
CDC Split Type:

Write-up: On 11/29/06 pt was listless, fed poorly and had 3 bloody mucousy stools. In my office the patient was pale and listless. The patient was refered to ER. An air contrast BE was diagnostic and therapeutic for the pt intussisption. The pt spent one night in hospital and is doing well.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=268134


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