National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 293751

Case Details

VAERS ID: 293751 (history)  
Form: Version 1.0  
Age: 0.4  
Gender: Male  
Location: Illinois  
Vaccinated:2007-08-13
Onset:2007-09-16
   Days after vaccination:34
Submitted: 2007-10-12
   Days after onset:26
Entered: 2007-10-19
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B137BA / 2 RL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 02564 / 2 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08692D / 2 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0694F / 2 MO / PO

Administered by: Private       Purchased by: Public
Symptoms: Intussusception
SMQs:, Gastrointestinal obstruction (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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None 12/10/07-records received-Barium enema reduction of colo-colonic intussusception with reflux of contrast into the terminal ileum.UGI no evidence of malrotation. Neutrophils 55%.
CDC Split Type:

Write-up: Rotateq vaccine given 8-13-07. Infant diagnosed and treated for intussusception 9/16/07.12/10/07-records received for DOS 9/16/07-DC DX: Intussusception. Barium enema reduction of colo-colonic intussusception with reflux of contrast into the terminal ileum. C/O vomiting and blood stools. Fussy.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=293751


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