National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 278006

Case Details

VAERS ID: 278006 (history)  
Form: Version 1.0  
Age: 0.5  
Gender: Female  
Location: California  
Vaccinated:2006-12-29
Onset:2007-04-26
   Days after vaccination:118
Submitted: 2007-05-02
   Days after onset:6
Entered: 2007-05-07
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR U1965AB / UNK LL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0032F / 3 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF018AD / 3 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Y10312 / 3 RL / SC
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08646C / 3 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1110F / 3 MO / PO

Administered by: Private       Purchased by: Private
Symptoms: Inappropriate schedule of drug administration, Intussusception
SMQs:, Gastrointestinal obstruction (narrow), Medication errors (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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: Hospitalized Abdominal US abnormal, barium enema cbc & chemistry both WNL.
CDC Split Type:

Write-up: Intussusception 5/15/07 Received vax records from reporter. Lot numbers corrected in VAERS database. RO lot number & dose confirmed by vax records. 5/25/07 Received medical records from hospital which reveal patient experienced emesis, bloody stools, abdominal pain & lethargy. IS at right hepatic flexure diagnosed by abd US & reduced by barium enema. Admitted 4/27 & d/c later same day after observation s/p IS reduction. Consult by peds surgery done. FINAL DX: Intussusception.


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=278006


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