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This is VAERS ID 305397

(NOTE: This result is from the 12/8/2009 version of the VAERS database)

Event Details

VAERS ID:305397 (history)  Vaccinated:2008-01-15
Age:0.3  Onset:2008-02-04, Days after vaccination: 20
Gender:Male  Submitted:2008-02-18, Days after onset: 14
Location:North Carolina  Entered:2008-02-21, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: 2/4/08, mild elevation of total 2.0 & direct 0.8 bilirubin and ALT 140/AST 79 enzymes; 2/11/08, abdominal ultrasound showed multiple gallstones
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)SANOFI PASTEURU2354BA1UNRL
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURZ087321UNLL
PNC: PNEUMO (PREVNAR)WYETH PHARMACEUTICALS, INCB70145A1UNLL
ROTHB5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.1244U1PO 
Administered by: Private     Purchased by: Public
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Blood bilirubin increased, Cholelithiasis, Faeces pale, Ultrasound abdomen abnormal
SMQs:, Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Biliary system related investigations, signs and symptoms (narrow), Gallbladder related disorders (narrow), Gallstone related disorders (narrow)
Write-up: 2/4/08 - Seen by patient''s pediatrician at office for stools with no color (acholic stools). Liver function panel: mild elevation of total bilirubin, direct bilirubin, and ALT/AST enzymes. 2/11/08 - Abdominal ultrasound showed multiple gallstones.

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Link To This Search Result:
http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20091208&IDNUMBER=305397


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