National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 279032

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

Case Details

VAERS ID: 279032 (history)  
Form: Version .0  
Age: 0.3  
Gender: Female  
Location: Kentucky  
Vaccinated:2006-11-07
Onset:2006-11-13
   Days after vaccination:6
Submitted: 2007-05-16
   Days after onset:183
Entered: 2007-05-18
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHE: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B065AA / 1 RL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1180R / 1 LL / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC B08649B / 1 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0726F / 1 - / PO

Administered by: Private       Purchased by: Unknown
Symptoms: Abdominal X-ray, Barium double contrast, Decreased appetite, 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? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Barium Enema LABS: air contrast barium enema x 2 reduced IS x 2.
CDC Split Type:

Write-up: Patient started with vomiting developed bloody stools. Transferred from one medical center hospital to another one for intussusception - reduced by air contrast barium enema on 11-14-06 and again 11-15-06.6/1/07 Received hospital medical records which rev"eal patient experienced vomiting, bloody stools & decreased appetite w/low grade fever. Seen at outlying ER which abdominal x-ray reveled possible SBO & IS. Transferred to higher level of care & admitted from 11/14-11/17/2006. IS successfully reduced bu


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20071231&IDNUMBER=279032


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