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This is VAERS ID 277882

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

Case Details

VAERS ID: 277882 (history)  
Form: Version .0  
Age: 0.4  
Gender: Female  
Location: Pennsylvania  
Vaccinated:2007-04-03
Onset:2007-04-26
   Days after vaccination:23
Submitted: 2007-05-03
   Days after onset:7
Entered: 2007-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2569AA / 1 LL / -
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF073AA / 1 RL / -
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC B08672K / 1 - / -
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1238F / 1 - / PO

Administered by: Private       Purchased by: Unknown
Symptoms: Abdominal X-ray, Barium double contrast, Blood test normal, 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? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Pilonydal dimple
Allergies:
Diagnostic Lab Data: Patient admitted to hospital overnight 4/27-4/28. Diagnosed w/intussusception reduced w/air.
CDC Split Type:

Write-up: Patient developed vomiting on 4/26/2007 on 4/27 parent report bilious vomiting episode 1 referred to hospital ED for evaluation.


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20071231&IDNUMBER=277882


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