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This is VAERS ID 284252

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

Case Details

VAERS ID: 284252 (history)  
Form: Version .0  
Age: 0.1  
Gender: Female  
Location: Texas  
Vaccinated:2007-04-05
Onset:2007-06-16
   Days after vaccination:72
Submitted: 2007-07-10
   Days after onset:24
Entered: 2007-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR 41813CA / 0 LL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0507F / 0 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Y0991 / 0 RL / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC B08674C / 0 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0979F / 0 - / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Barium enema, Diarrhoea, Explorative laparotomy, Haematochezia, Intussusception
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: Labs and Diagnostics: KUB (done at previous facility) showed dilated bowel loops and air throughout. WBCs 22,000. Platelets 579,000. Chem WNL. UA (-). Abd ultrasound with eveidence of a mass-effect in the RUQ c/w Intussusception. Bariu
CDC Split Type:

Write-up: Intussusception. Surgical correction in June 2007.


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