National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 277899

(NOTE: This result is from the 8/31/2010 version of the VAERS database)

Case Details

VAERS ID: 277899 (history)  
Form: Version .0  
Age: 0.2  
Gender: Female  
Location: Unknown  
Vaccinated:2007-03-29
Onset:2007-04-23
   Days after vaccination:25
Submitted: 2007-05-03
   Days after onset:10
Entered: 2007-05-04
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C21521AA / 0 LL / -
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0757F / 0 RL / -
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0306 / 0 RL / -
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08681D / 0 LL / -
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1239F / 0 UN / -

Administered by: Other       Purchased by: Other
Symptoms: Abdominal X-ray, Barium double contrast, Haematochezia, Intussusception, Irritability, Ultrasound abdomen abnormal, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal haemorrhage (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), 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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Barium enema X-ray
CDC Split Type: WAES0704USA05624

Write-up: Information has been received from a physician concerning a 11 week female who on 29-MAR-2007 was vaccinated with the first dose of Rotateq (Lot # 656189/1239F). Concomitant vaccinations included Dtap, PREVNAR, Comvax, poliovirus vaccine. On 23-APR-2007, the patient experienced intussusception and was hospitalized and given an air contrast enema. The patient recovered from intussusception on 25-APR-2007. Additional information has been requested. 5/15/07 Received vax record which confirmed RO Lot & dose as reported. VAERS database updated w/additional vax info from same date. 5/22/07 Received hospital medical records which reveal patient experienced irritability, bilious vomiting & bloody stool x 1 day. Seen in ER on 4/23 & dx w/IS by barium enema which also reduced successfully. Kept for overnight observation s/p reduction & progressed well. D/C home 4/24/07. Returned to ER on 4/27/07 for irritability/crying w/BM. Abdominal x-ray revealed nonspecific bowel gas pattern. US of abd was WNL & pt was d/c to home.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20100831&IDNUMBER=277899


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