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This is VAERS ID 281426

(NOTE: This result is from the 3/2/2010 version of the VAERS database)

Case Details

VAERS ID: 281426 (history)  
Form: Version .0  
Age: 0.3  
Gender: Female  
Location: Alabama  
Vaccinated:2006-12-28
Onset:2007-01-29
   Days after vaccination:32
Submitted: 2007-06-12
   Days after onset:133
Entered: 2007-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER C2490AA5108 / 1 RL / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER UF058AA11108 / 1 RL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER Z03244108 / 1 LL / IM
PNC: PNEUMO (PREVNAR7) / WYETH PHARMACEUTICALS, INC B08470K12107 / 1 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0847F4108 / 1 - / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Abdominal pain, Barium double contrast, Diarrhoea, Fluid replacement, Intussusception, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (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? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Culturelle and a homeopathic antidiarrheal medication
Current Illness: Vomiting and diarrhea with some blood in the stool
Preexisting Conditions: None.
Allergies:
Diagnostic Lab Data: Air contrast enema (see above)
CDC Split Type:

Write-up: Was admitted to hospital 1/31/07 with abdomenal pain, vomiting and diarrhea. An air contrast enema during the hospitalization was felt to be consistent with intussusception. This resolved after the enema. The child received IV fluids and was subsequently discharged home in good condition. 06/14/07-records received for DOS 01/37/07-Successful reduction of ileocolic intussusception by air enema. Presented to ER with vomiting and diarrhea. Diarrhea started 4 days ago. Loose stools some with blood in stool initially but this has cleared. Nonbilious, nonbloody vomiting. Decreased PO Intake. Vaccination record received supports data submitted. No discharge summary dictated.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20100302&IDNUMBER=281426


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