National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 288089

Case Details

VAERS ID: 288089 (history)  
Form: Version 1.0  
Age: 0.3  
Gender: Male  
Location: Pennsylvania  
Vaccinated:2007-05-25
Onset:2007-08-01
   Days after vaccination:68
Submitted: 2007-08-14
   Days after onset:13
Entered: 2007-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2651AA / 2 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UE921AA / 2 LL / ID
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0872 / 2 RL / ID
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08692F / 2 LA / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0236U / 2 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Appendicectomy, Diarrhoea, Explorative laparotomy, Intussusception, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal obstruction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A. PMH: URI 5 days ago, Varicella infection 2 weeks ago
Allergies:
Diagnostic Lab Data: exploratory laparotomy, reduction of intussusception, appendectomy. Labs and Diagnostics: Abdominal US (+) for IS. Air contrast barium enema which partially reduced the IS.
CDC Split Type:

Write-up: vomiting, diarrhea. D/C summary received for DOS 8/3-4/2007 for DX of Intussusception made at another facility. Infant had Air contrast barium enema which partially reduced the IS. Taken to OR for open reduction of intussusception and appendectomy. D/C DX: Intussusception.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=288089


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