National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 286278

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

Case Details

VAERS ID: 286278 (history)  
Form: Version .0  
Age: 0.2  
Gender: Male  
Location: Unknown  
Vaccinated:2007-05-31
Onset:2007-07-09
   Days after vaccination:39
Submitted: 2007-07-26
   Days after onset:17
Entered: 2007-07-31
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHE: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B101AA / 0 UN / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0205U / 0 UN / UN
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC B08690A / 0 UN / UN
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0407U / 0 - / PO

Administered by: Other       Purchased by: Unknown
Symptoms: Abdominal X-ray, Appendicectomy, Bacteraemia, Blood culture positive, Blood glucose increased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Information has been received from a physician concerning a 15 week old male who on 31-MAY-2007 was vaccinated with Rotateq (Lot# 656833/0407U). Concomitant therapy included Pediarix, Hib conj vaccine (unspecified carrier) and Prevnar. The physician repor"ted that the child was vomiting profusely on the morning of 09-JUL-2007 and was taken to the hospital. The physician reported the child was transferred to another hospital. The child was found to have an intussusception. The physician reported that the pa


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20071231&IDNUMBER=286278


Copyright © 2019 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166