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This is VAERS ID 272462

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

Case Details

VAERS ID: 272462 (history)  
Form: Version .0  
Age: 0.5  
Gender: Female  
Location: Maryland  
Vaccinated:2007-01-24
Onset:2007-02-17
   Days after vaccination:24
Submitted: 2007-02-17
   Days after onset:0
Entered: 2007-02-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHE: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 - / -
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC - / 1 - / -
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0940F / 1 - / SC

Administered by: Unknown       Purchased by: Unknown
Symptoms: Barium double contrast, Enteroenterostomy, Haematochezia, Intussusception
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: no
Allergies:
Diagnostic Lab Data: Air contrast enema x 2
CDC Split Type:

Write-up: intussussception


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http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20071231&IDNUMBER=272462


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