National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 299129

Case Details

VAERS ID: 299129 (history)  
Form: Version 1.0  
Age: 0.2  
Gender: Female  
Location: Minnesota  
Vaccinated:2007-11-07
Onset:2007-12-04
   Days after vaccination:27
Submitted: 2007-12-10
   Days after onset:6
Entered: 2007-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B125CB / 1 LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0257U / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08700K / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0969U / 1 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Barium double contrast, Intussusception
SMQs:, Gastrointestinal obstruction (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None 1/10/08-records received- PMH: unrepaired umbilical hernia.
Allergies:
Diagnostic Lab Data: Air Contrast Enema with confirmed intussuseption 1/10/08-records received-Hemoglobin 8.8. Air contrast enema: outlining intussusception in region of hepatic flexure of colon. Successful pneumatic reduction of ileocolic intussusception. UGI with KUB:suspicious for small bowel obstruction. No evidence of malrotation. Blood culture no growth. Stool positive for Clostridium difficile toxin A and or B.
CDC Split Type:

Write-up: Documented case of Intussusecption 4 weeks after dose of Rotateq. 1/10/08-records received for DOS 12/4-12/7/07-DC DX: Intussusception. Hematochezia, resolved.Vomiting resolved. Physiologic anemia in infancy. C/O bright red blood from rectum, emesis, vomiting projectile in nature. Decreased appetite and increased sleep.


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=299129


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