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This is VAERS ID 282652

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

Case Details

VAERS ID: 282652 (history)  
Form: Version .0  
Age: 0.5  
Gender: Female  
Location: Louisiana  
Vaccinated:2007-01-08
Onset:2007-03-10
   Days after vaccination:61
Submitted: 2007-06-21
   Days after onset:102
Entered: 2007-06-22
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHE: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B079BA / 2 RL / UN
FLU: INFLUENZA (FLUZONE 00-01) / AVENTIS PASTEUR UT2M4LA / 0 LL / -
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC B08620K / 2 LL / UN
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1115F / 2 - / PO

Administered by: Other       Purchased by: Unknown
Symptoms: Abdominal X-ray, Blood culture negative, Computerised tomogram abnormal, Constipation, Enema administration
SMQs:, 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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Information has been received from a physician concerning a 6-month-old female with no medical history or allergies who on 15-SEP-2006 (Lot #655082/0779F), 02-NOV-2006 (Lot #655174/0848F) and 08-JAN-2007 (Lot #655407/1115F) was vaccinated PO with the firs"t, second and third doses, respectively, of ROTATEQ. Concomitant vaccinations administered on that same day included a dose of PREVNAR, a dose of PEDVAXHIB and a dose of PEDIARIX. The physician reported that two and a half weeks after receiving the third


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