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This is VAERS ID 279315

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

Case Details

VAERS ID: 279315 (history)  
Form: Version .0  
Age: 0.6  
Gender: Female  
Location: Connecticut  
Vaccinated:2007-03-28
Onset:2007-05-10
   Days after vaccination:43
Submitted: 2007-05-18
   Days after onset:8
Entered: 2007-05-23
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHE: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B097AB / 2 LL / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC B08670H / 2 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1165F / 1 - / PO

Administered by: Public       Purchased by: Unknown
Symptoms: Appendicectomy, Barium double contrast, Blood electrolytes normal, Constipation, Dehydration
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? Yes
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: Abdominal ultrasound, air enema
CDC Split Type:

Write-up: Intussusception requiring surgical reduction


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Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20071231&IDNUMBER=279315


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