National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 281381

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

Case Details

VAERS ID: 281381 (history)  
Form: Version .0  
Age: 0.2  
Gender: Male  
Location: Tennessee  
Vaccinated:2007-05-31
Onset:2007-06-05
   Days after vaccination:5
Submitted: 2007-06-07
   Days after onset:2
Entered: 2007-06-12
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHE: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B110AB / 0 UN / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UE923AA / 0 UN / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC B08679A / 0 UN / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1167F / 0 - / PO

Administered by: Private       Purchased by: Unknown
Symptoms: Appendicectomy, Barium double contrast, Intussusception, Laboratory test normal
SMQs:, Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Perinatal drug (marijuana) exposure
Allergies:
Diagnostic Lab Data: KUB with dilated loops of bowel records received 6/20/07-Labs: normal electrolyte panel. WBC 14.5. KUB showed multiple dilated gas filled loops of bowel suspicious for developing bowel obstruction. Air enema demonstrated ileocolic intussus
CDC Split Type:

Write-up: Intussusception, attempted air contrast enema without resolution. Taken to surgery for repair. Was reduced in surgery; no bowel was resected/remained. 06/13/07-records requested from facility and from pcp for vac rec. krk 6/20/07-vac rec received, support"s submitted documentation on VAERS form. No changes. krk 06/20/07-records received from facility for DOS-6/6-6/7/07- DC DX: Intussusception, Status Post exploratory laparotomy and appendectomy. On 6/5/07 at 7 a.m. began to vomit after feeding. Refusing bo


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20071231&IDNUMBER=281381


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