National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 278389

(NOTE: This result is from the 4/7/2010 version of the VAERS database)

Case Details

VAERS ID: 278389 (history)  
Form: Version .0  
Age: 0.4  
Gender: Female  
Location: Arkansas  
Vaccinated:2007-04-13
Onset:2007-05-01
   Days after vaccination:18
Submitted: 2007-05-11
   Days after onset:10
Entered: 2007-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2553AA / 1 LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1014F / 1 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / SANOFI PASTEUR Z0306-2 / 1 LL / SC
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC BO8691 / 1 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1365F / 1 - / PO

Administered by: Private       Purchased by: Unknown
Symptoms: Abdominal X-ray, Appendicectomy, Decreased appetite, Dehydration, Enema administration, Haematochezia, Intussusception, Lethargy, Small intestinal obstruction, Surgery, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), 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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: LABS: abdominal x-ray revealed SBO. Contrast study revealed mid transverse IS which reduced s/p several attempts.
CDC Split Type:

Write-up: Two weeks after receiving Rotateq - 05/03/07 dx with intussusception - requiring surgical intervention. 5/22/07 Received vax records & operative note from PCP which reveals patient experienced intussusception which was initially reduced by contrast. However, symptoms persisted & contrast study was repeated which revealed recurence of IS right at ileocecal valve & patient taken to OR. Findings at surgery were ileoileal IS successfully reduced w/o difficulty, Peyer patch & incidental appendectomy was done. Vax record corrects lot numbers, VAERS database updated. 7/17/07 Received hospital medical records which reveal patient experienced vomiting, bloody stool, lethargy, dehydration & decreased appetite. FINAL DX: Intussusception.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20100407&IDNUMBER=278389


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