National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 273520

(NOTE: This result is from the 2/14/2017 version of the VAERS database)

Case Details

VAERS ID: 273520 (history)  
Form: Version .0  
Age: 0.4  
Gender: Male  
Location: Alabama  
Vaccinated:2006-12-13
Onset:2007-02-26
   Days after vaccination:75
Submitted: 2007-02-27
   Days after onset:1
Entered: 2007-03-07
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / SANOFI PASTEUR U1891BA / 1 LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 6086F / 1 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Y1032 / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08675K / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0319F / 2 - / PO

Administered by: Private       Purchased by: Private
Symptoms: Agitation, Barium enema, Haematochezia, Intussusception, Lethargy, Surgery
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Ischaemic colitis (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: 11-7-06 Polytrim opthalmic drops
Current Illness: Well check up
Preexisting Conditions: Heart murmur 9-11-06
Allergies:
Diagnostic Lab Data: BE diagnosis Records received 5/15/07-Barium enema revealed intussusception. Unsuccessful in reduction.
CDC Split Type:

Write-up: Pt had signs of alternating lethargy, fussiness and a bloody stool. Diagnosed with intussusception by BE which failed to reduce it. Went to surgery and his appendix was lead point. Doubt due to Rotateq 2 mos after dose and appendix lead point. 05/15/07-records received for DOS 2/26-3/2/07. DC DX: Intussusception.Several hour history of sleeping a lot waking up crying not eating well. Vomited once. No diarrhea. Rectal exam revealed hempositive secretions. Barium enema revealed intussusception. Unsuccessful in reduction. Surgical reduction revealed appendix in the middle of the intussusception.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20170214&IDNUMBER=273520


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