National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 273374

(NOTE: This result is from the 6/11/2011 version of the VAERS database)

Case Details

VAERS ID: 273374 (history)  
Form: Version .0  
Age: 0.3  
Gender: Female  
Location: Arizona  
Vaccinated:2007-01-16
Onset:2007-02-19
   Days after vaccination:34
Submitted: 2007-03-05
   Days after onset:14
Entered: 2007-03-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B084CA / 1 RL / -
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1270F / 1 LL / -
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B47442A / 1 LL / -
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1111F / - - / -

Administered by: Private       Purchased by: Private
Symptoms: Barium double contrast, Chest X-ray normal, Computerised tomogram, Computerised tomogram normal, Haematemesis, Intussusception, Lymphocyte count, Lymphocyte count increased, Occult blood positive, Ultrasound scan, Urinary system X-ray, Urine ketone body present, Vomiting, X-ray
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CT, X-rays, Sonogram records received 3/36/07-Abdominal ultrasound revealed right lower quadrant intussusception with atypical swirl appearance of intussusception. Barium enema with resolution of intussusception. CXR and KUB normal. CT head normal. WBC 13.3, neutrophils 68%, lymphycotes 25%. Urine 2+ ketones.
CDC Split Type:

Write-up: Intussusception R lower quadrant. 03/26/07-records received from facility for DOS 02/19-02/21/07-DC DX: Intussusception. Vomiting, non-bilious however became bilious with small amounts of blood while in hospital. Several loose stools heme positive.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20110611&IDNUMBER=273374


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