National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 281029

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

Case Details

VAERS ID: 281029 (history)  
Form: Version .0  
Age: 0.5  
Gender: Male  
Location: Unknown  
Vaccinated:2007-05-14
Onset:2007-05-26
   Days after vaccination:12
Submitted: 2007-06-07
   Days after onset:12
Entered: 2007-06-08
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / SANOFI PASTEUR U1965BA / 2 RL / UN
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC B08666K / 2 LL / UN
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0030U / 1 - / PO

Administered by: Other       Purchased by: Unknown
Symptoms: Abdominal X-ray, Barium double contrast, Dehydration, Intussusception, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown PMH: parent w/recent stomach virus
Allergies:
Diagnostic Lab Data: abdominal X-ray 05/26/07 LABS: abdominal x-ray revealed possible mass effect in RUQ. Air enema revealed IS & also reduced it.
CDC Split Type:

Write-up: Information has been received from a physician concerning a 6 month old male who on 14-MAY-2007 was vaccinated with the third 2 ml oral dose of Rotateq (Lot # 656385/0030U). Concomitant therapy included DTaP (+) Prevnar. On 26-MAY-2007, the patient experi"enced intussusception. An abdominal x-ray was performed in the emergency room. Intussusception was located in the right upper quadrant and was reduced via of air enema with no difficulty. On 26-MAY-2007, the patient recovered from intussusception. Intussu


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20071231&IDNUMBER=281029


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