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This is VAERS ID 275606

(NOTE: This result is from the 5/13/2013 version of the VAERS database)

Case Details

VAERS ID: 275606 (history)  
Form: Version .0  
Age: 0.5  
Gender: Female  
Location: California  
Vaccinated:2006-11-14
Onset:2007-03-16
   Days after vaccination:122
Submitted: 2007-04-04
   Days after onset:19
Entered: 2007-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / AVENTIS PASTEUR C2489AA / 2 RL / IM
PNC: PNEUMO (PREVNAR) / LEDERLE LABORATORIES BO8658B / 2 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0776F / 0 - / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Abdominal pain, Barium double contrast, Diarrhoea, Haematochezia, Intussusception, Pyrexia, Ultrasound scan abnormal
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad)

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:
Current Illness: no records received 4/24/07- Slight fever, mild congestion, cough and slight drainage from right eye over past 2 days.
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: ultrasound showed intussesception records received 4/24/07-US abdomen:intussusception. Stool WBC and RBC present.
CDC Split Type:

Write-up: intusseseption 04/24/07-records received from facility for DOS 03/16-03/17/07-DC DX:Intussusception. Admitted for observation after successful reduction of intussesception by air enema. Presented with abdominal pain, bloody stool. Cramping, colicky intermittent. 10 stools in past 24 hours, bloody stools.


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http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20130513&IDNUMBER=275606


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