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This is VAERS ID 271927

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

Case Details

VAERS ID: 271927 (history)  
Form: Version .0  
Age: 0.5  
Gender: Male  
Location: Connecticut  
Vaccinated:2007-01-29
Onset:2007-02-07
   Days after vaccination:9
Submitted: 2007-02-07
   Days after onset:0
Entered: 2007-02-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHE: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B097AB / 2 UN / IM
FLU: INFLUENZA (FLUZONE) / AVENTIS PASTEUR UT2191KA / 0 UN / IM
PNC: PNEUMO (PREVNAR) / LEDERLE LABORATORIES B08691A / 2 UN / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0942F / 2 - / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Barium double contrast, Body temperature increased, Cough, Dehydration, Diarrhoea
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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, 2 days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: recurrent wheezing, h/o RSV bronchiolitis (Nov 2006), eczema
Allergies:
Diagnostic Lab Data: Stool culture and viral studies to be done. Ultrasound showed ileocolic intussecptus and patient was transferred today. Outcome not known yet.
CDC Split Type:

Write-up: Patient developed explosive diarrhea and emesis shortly after vaccine given. On 2/6/07 he was admitted for worsening vomiting, and on the morning of 2/7/07 he was found to have intussusception.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20071231&IDNUMBER=271927


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