National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 312127

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2008

VAERS ID: 312127
VAERS Form:
Age:0.3
Sex:Male
Location:Maryland
Vaccinated:2008-03-11
Onset:2008-04-04
Submitted:2008-05-12
Entered:2008-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2935AA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF355AA / 1 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0170-2 / 1 LL / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC B47442H / 1 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0968U / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Appendicectomy, Barium double contrast, Crying, Abdominal X-ray

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: 9/11/08-records received-Abdominal x-ray consistent with intussusception. Air contrast enema revealed obstruction at left side of bowel. Incomplete reduction by air contrast enema. two episodes of bilious emesis on 4/9/08. Abdominal US and
CDC 'Split Type':

Write-up: 4/4/08 Patient started having vomiting with every feeds. Initially diagnosed as gastroenteritis. Went to Emergency Dept 4/4/08, 4/6/08, and our office 4/7/08. Diagnosed with intussucsception 4/8/08. Unable to be reduced by radiology, and required surg"ery. Had surgery for intussusception 4/8/08 and appendectomy. 9/11/08-records received for DOS 4/8-4/14/08-DC DX:Intussusception status post reduction and appendectomy. Presented with 4 day history of vomiting after every feeding, crying and increased fu


Changed on 12/8/2009

VAERS ID: 312127 Before After
VAERS Form:
Age:0.3
Sex:Male
Location:Maryland
Vaccinated:2008-03-11
Onset:2008-04-04
Submitted:2008-05-12
Entered:2008-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2935AA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF355AA / 1 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0170-2 / 1 LL / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC B47442H / 1 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0968U / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Appendicectomy, Barium double contrast, Crying, Intussusception, Irritability, Surgery, Vomiting, X-ray abnormal, Gastrointestinal tube insertion, Abdominal X-ray

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: 9/11/08-records received-Abdominal x-ray consistent with intussusception. Air contrast enema revealed obstruction at left side of bowel. Incomplete reduction by air contrast enema. two episodes of bilious emesis on 4/9/08. Abdominal US and
CDC 'Split Type':

Write-up: 4/4/08 Patient started having vomiting with every feeds. Initially diagnosed as gastroenteritis. Went to Emergency Dept 4/4/08, 4/6/08, and our office 4/7/08. Diagnosed with intussucsception 4/8/08. Unable to be reduced by radiology, and required surg"ery. surgery. Had surgery for intussusception 4/8/08 and appendectomy. 9/11/08-records received for DOS 4/8-4/14/08-DC DX:Intussusception status post reduction and appendectomy. Presented with 4 day history of vomiting after every feeding, crying and increased fu fussiness. Post operatively had increased distention and had NG tube placement after two episodes of bilious emesis on 4/9/08. Abdominal US and x-ray and barium enema did not revealed repeat intussusception. NG removed tolerating fluids.


Changed on 3/2/2010

VAERS ID: 312127 Before After
VAERS Form:
Age:0.3
Sex:Male
Location:Maryland
Vaccinated:2008-03-11
Onset:2008-04-04
Submitted:2008-05-12
Entered:2008-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2935AA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF355AA / 1 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0170-2 / 1 LL / IM
PNC: PNEUMO (PREVNAR) PNEUMO (PREVNAR7) / WYETH PHARMACEUTICALS, INC B47442H / 1 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0968U / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Appendicectomy, Barium double contrast, Crying, Intussusception, Irritability, Surgery, Vomiting, X-ray abnormal, Gastrointestinal tube insertion, Abdominal X-ray

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: 9/11/08-records received-Abdominal x-ray consistent with intussusception. Air contrast enema revealed obstruction at left side of bowel. Incomplete reduction by air contrast enema. two episodes of bilious emesis on 4/9/08. Abdominal US and
CDC 'Split Type':

Write-up: 4/4/08 Patient started having vomiting with every feeds. Initially diagnosed as gastroenteritis. Went to Emergency Dept 4/4/08, 4/6/08, and our office 4/7/08. Diagnosed with intussucsception 4/8/08. Unable to be reduced by radiology, and required surgery. Had surgery for intussusception 4/8/08 and appendectomy. 9/11/08-records received for DOS 4/8-4/14/08-DC DX:Intussusception status post reduction and appendectomy. Presented with 4 day history of vomiting after every feeding, crying and increased fussiness. Post operatively had increased distention and had NG tube placement after two episodes of bilious emesis on 4/9/08. Abdominal US and x-ray and barium enema did not revealed repeat intussusception. NG removed tolerating fluids.


Changed on 4/7/2010

VAERS ID: 312127 Before After
VAERS Form:
Age:0.3
Sex:Male
Location:Maryland
Vaccinated:2008-03-11
Onset:2008-04-04
Submitted:2008-05-12
Entered:2008-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2935AA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF355AA / 1 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0170-2 / 1 LL / IM
PNC: PNEUMO (PREVNAR7) PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC B47442H / 1 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0968U / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Appendicectomy, Barium double contrast, Crying, Intussusception, Irritability, Surgery, Vomiting, X-ray abnormal, Gastrointestinal tube insertion, Abdominal X-ray

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: 9/11/08-records received-Abdominal x-ray consistent with intussusception. Air contrast enema revealed obstruction at left side of bowel. Incomplete reduction by air contrast enema. two episodes of bilious emesis on 4/9/08. Abdominal US and
CDC 'Split Type':

Write-up: 4/4/08 Patient started having vomiting with every feeds. Initially diagnosed as gastroenteritis. Went to Emergency Dept 4/4/08, 4/6/08, and our office 4/7/08. Diagnosed with intussucsception 4/8/08. Unable to be reduced by radiology, and required surgery. Had surgery for intussusception 4/8/08 and appendectomy. 9/11/08-records received for DOS 4/8-4/14/08-DC DX:Intussusception status post reduction and appendectomy. Presented with 4 day history of vomiting after every feeding, crying and increased fussiness. Post operatively had increased distention and had NG tube placement after two episodes of bilious emesis on 4/9/08. Abdominal US and x-ray and barium enema did not revealed repeat intussusception. NG removed tolerating fluids.


Changed on 8/31/2010

VAERS ID: 312127 Before After
VAERS Form:
Age:0.3
Sex:Male
Location:Maryland
Vaccinated:2008-03-11
Onset:2008-04-04
Submitted:2008-05-12
Entered:2008-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2935AA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF355AA / 1 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0170-2 / 1 LL / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH B47442H / 1 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0968U / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Appendicectomy, Barium double contrast, Crying, Intussusception, Irritability, Surgery, Vomiting, X-ray abnormal, Gastrointestinal tube insertion, Abdominal X-ray

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: 9/11/08-records received-Abdominal x-ray consistent with intussusception. Air contrast enema revealed obstruction at left side of bowel. Incomplete reduction by air contrast enema. two episodes of bilious emesis on 4/9/08. Abdominal US and
CDC 'Split Type':

Write-up: 4/4/08 Patient started having vomiting with every feeds. Initially diagnosed as gastroenteritis. Went to Emergency Dept 4/4/08, 4/6/08, and our office 4/7/08. Diagnosed with intussucsception 4/8/08. Unable to be reduced by radiology, and required surgery. Had surgery for intussusception 4/8/08 and appendectomy. 9/11/08-records received for DOS 4/8-4/14/08-DC DX:Intussusception status post reduction and appendectomy. Presented with 4 day history of vomiting after every feeding, crying and increased fussiness. Post operatively had increased distention and had NG tube placement after two episodes of bilious emesis on 4/9/08. Abdominal US and x-ray and barium enema did not revealed repeat intussusception. NG removed tolerating fluids.


Changed on 5/13/2013

VAERS ID: 312127 Before After
VAERS Form:
Age:0.3
Sex:Male
Location:Maryland
Vaccinated:2008-03-11
Onset:2008-04-04
Submitted:2008-05-12
Entered:2008-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2935AA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF355AA / 1 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0170-2 / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B47442H / 1 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0968U / 0 - / PO
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0968U / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Appendicectomy, Barium double contrast, Crying, Intussusception, Irritability, Surgery, Vomiting, X-ray abnormal, Gastrointestinal tube insertion, Abdominal X-ray

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: 9/11/08-records received-Abdominal x-ray consistent with intussusception. Air contrast enema revealed obstruction at left side of bowel. Incomplete reduction by air contrast enema. two episodes of bilious emesis on 4/9/08. Abdominal US and
CDC 'Split Type':

Write-up: 4/4/08 Patient started having vomiting with every feeds. Initially diagnosed as gastroenteritis. Went to Emergency Dept 4/4/08, 4/6/08, and our office 4/7/08. Diagnosed with intussucsception 4/8/08. Unable to be reduced by radiology, and required surgery. Had surgery for intussusception 4/8/08 and appendectomy. 9/11/08-records received for DOS 4/8-4/14/08-DC DX:Intussusception status post reduction and appendectomy. Presented with 4 day history of vomiting after every feeding, crying and increased fussiness. Post operatively had increased distention and had NG tube placement after two episodes of bilious emesis on 4/9/08. Abdominal US and x-ray and barium enema did not revealed repeat intussusception. NG removed tolerating fluids.


Changed on 4/14/2017

VAERS ID: 312127 Before After
VAERS Form:
Age:0.3
Sex:Male
Location:Maryland
Vaccinated:2008-03-11
Onset:2008-04-04
Submitted:2008-05-12
Entered:2008-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2935AA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF355AA / 1 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0170-2 / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B47442H / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0968U / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Appendicectomy, Barium double contrast, Crying, Intussusception, Irritability, Surgery, Vomiting, X-ray abnormal, Gastrointestinal tube insertion, Abdominal X-ray

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: 9/11/08-records received-Abdominal x-ray consistent with intussusception. Air contrast enema revealed obstruction at left side of bowel. Incomplete reduction by air contrast enema. two episodes of bilious emesis on 4/9/08. Abdominal US and x-ray and barium enema did not revealed repeat intussusception.
CDC 'Split Type':

Write-up: 4/4/08 Patient started having vomiting with every feeds. Initially diagnosed as gastroenteritis. Went to Emergency Dept 4/4/08, 4/6/08, and our office 4/7/08. Diagnosed with intussucsception 4/8/08. Unable to be reduced by radiology, and required surgery. Had surgery for intussusception 4/8/08 and appendectomy. 9/11/08-records received for DOS 4/8-4/14/08-DC DX:Intussusception status post reduction and appendectomy. Presented with 4 day history of vomiting after every feeding, crying and increased fussiness. Post operatively had increased distention and had NG tube placement after two episodes of bilious emesis on 4/9/08. Abdominal US and x-ray and barium enema did not revealed repeat intussusception. NG removed tolerating fluids.


Changed on 9/14/2017

VAERS ID: 312127 Before After
VAERS Form:(blank) 1
Age:0.3
Sex:Male
Location:Maryland
Vaccinated:2008-03-11
Onset:2008-04-04
Submitted:2008-05-12
Entered:2008-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2935AA / 1 2 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF355AA / 1 2 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0170-2 / 1 2 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B47442H / 1 2 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0968U / 0 1 - MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Appendicectomy, Intussusception, Surgery, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: 9/11/08-records received-Abdominal x-ray consistent with intussusception. Air contrast enema revealed obstruction at left side of bowel. Incomplete reduction by air contrast enema. two episodes of bilious emesis on 4/9/08. Abdominal US and x-ray and barium enema did not revealed repeat intussusception.
CDC 'Split Type':

Write-up: 4/4/08 Patient started having vomiting with every feeds. Initially diagnosed as gastroenteritis. Went to Emergency Dept 4/4/08, 4/6/08, and our office 4/7/08. Diagnosed with intussucsception 4/8/08. Unable to be reduced by radiology, and required surgery. Had surgery for intussusception 4/8/08 and appendectomy. 9/11/08-records received for DOS 4/8-4/14/08-DC DX:Intussusception status post reduction and appendectomy. Presented with 4 day history of vomiting after every feeding, crying and increased fussiness. Post operatively had increased distention and had NG tube placement after two episodes of bilious emesis on 4/9/08. Abdominal US and x-ray and barium enema did not revealed repeat intussusception. NG removed tolerating fluids.


Changed on 2/14/2018

VAERS ID: 312127 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Maryland
Vaccinated:2008-03-11
Onset:2008-04-04
Submitted:2008-05-12
Entered:2008-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2935AA / 2 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF355AA / 2 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0170-2 / 2 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B47442H / 2 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0968U / 1 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Appendicectomy, Intussusception, Surgery, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: 9/11/08-records received-Abdominal x-ray consistent with intussusception. Air contrast enema revealed obstruction at left side of bowel. Incomplete reduction by air contrast enema. two episodes of bilious emesis on 4/9/08. Abdominal US and x-ray and barium enema did not revealed repeat intussusception.
CDC 'Split Type':

Write-up: 4/4/08 Patient started having vomiting with every feeds. Initially diagnosed as gastroenteritis. Went to Emergency Dept 4/4/08, 4/6/08, and our office 4/7/08. Diagnosed with intussucsception 4/8/08. Unable to be reduced by radiology, and required surgery. Had surgery for intussusception 4/8/08 and appendectomy. 9/11/08-records received for DOS 4/8-4/14/08-DC DX:Intussusception status post reduction and appendectomy. Presented with 4 day history of vomiting after every feeding, crying and increased fussiness. Post operatively had increased distention and had NG tube placement after two episodes of bilious emesis on 4/9/08. Abdominal US and x-ray and barium enema did not revealed repeat intussusception. NG removed tolerating fluids.


Changed on 6/14/2018

VAERS ID: 312127 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Maryland
Vaccinated:2008-03-11
Onset:2008-04-04
Submitted:2008-05-12
Entered:2008-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2935AA / 2 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF355AA / 2 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0170-2 / 2 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B47442H / 2 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0968U / 1 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Appendicectomy, Intussusception, Surgery, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: 9/11/08-records received-Abdominal x-ray consistent with intussusception. Air contrast enema revealed obstruction at left side of bowel. Incomplete reduction by air contrast enema. two episodes of bilious emesis on 4/9/08. Abdominal US and x-ray and barium enema did not revealed repeat intussusception.
CDC 'Split Type':

Write-up: 4/4/08 Patient started having vomiting with every feeds. Initially diagnosed as gastroenteritis. Went to Emergency Dept 4/4/08, 4/6/08, and our office 4/7/08. Diagnosed with intussucsception 4/8/08. Unable to be reduced by radiology, and required surgery. Had surgery for intussusception 4/8/08 and appendectomy. 9/11/08-records received for DOS 4/8-4/14/08-DC DX:Intussusception status post reduction and appendectomy. Presented with 4 day history of vomiting after every feeding, crying and increased fussiness. Post operatively had increased distention and had NG tube placement after two episodes of bilious emesis on 4/9/08. Abdominal US and x-ray and barium enema did not revealed repeat intussusception. NG removed tolerating fluids.


Changed on 8/14/2018

VAERS ID: 312127 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Maryland
Vaccinated:2008-03-11
Onset:2008-04-04
Submitted:2008-05-12
Entered:2008-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2935AA / 2 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF355AA / 2 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0170-2 / 2 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B47442H / 2 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0968U / 1 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Appendicectomy, Intussusception, Surgery, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: 9/11/08-records received-Abdominal x-ray consistent with intussusception. Air contrast enema revealed obstruction at left side of bowel. Incomplete reduction by air contrast enema. two episodes of bilious emesis on 4/9/08. Abdominal US and x-ray and barium enema did not revealed repeat intussusception.
CDC 'Split Type':

Write-up: 4/4/08 Patient started having vomiting with every feeds. Initially diagnosed as gastroenteritis. Went to Emergency Dept 4/4/08, 4/6/08, and our office 4/7/08. Diagnosed with intussucsception 4/8/08. Unable to be reduced by radiology, and required surgery. Had surgery for intussusception 4/8/08 and appendectomy. 9/11/08-records received for DOS 4/8-4/14/08-DC DX:Intussusception status post reduction and appendectomy. Presented with 4 day history of vomiting after every feeding, crying and increased fussiness. Post operatively had increased distention and had NG tube placement after two episodes of bilious emesis on 4/9/08. Abdominal US and x-ray and barium enema did not revealed repeat intussusception. NG removed tolerating fluids.


Changed on 9/14/2018

VAERS ID: 312127 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Maryland
Vaccinated:2008-03-11
Onset:2008-04-04
Submitted:2008-05-12
Entered:2008-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2935AA / 2 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF355AA / 2 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0170-2 / 2 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B47442H / 2 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0968U / 1 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Appendicectomy, Intussusception, Surgery, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: 9/11/08-records received-Abdominal x-ray consistent with intussusception. Air contrast enema revealed obstruction at left side of bowel. Incomplete reduction by air contrast enema. two episodes of bilious emesis on 4/9/08. Abdominal US and x-ray and barium enema did not revealed repeat intussusception.
CDC 'Split Type':

Write-up: 4/4/08 Patient started having vomiting with every feeds. Initially diagnosed as gastroenteritis. Went to Emergency Dept 4/4/08, 4/6/08, and our office 4/7/08. Diagnosed with intussucsception 4/8/08. Unable to be reduced by radiology, and required surgery. Had surgery for intussusception 4/8/08 and appendectomy. 9/11/08-records received for DOS 4/8-4/14/08-DC DX:Intussusception status post reduction and appendectomy. Presented with 4 day history of vomiting after every feeding, crying and increased fussiness. Post operatively had increased distention and had NG tube placement after two episodes of bilious emesis on 4/9/08. Abdominal US and x-ray and barium enema did not revealed repeat intussusception. NG removed tolerating fluids.


Changed on 10/14/2018

VAERS ID: 312127 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Maryland
Vaccinated:2008-03-11
Onset:2008-04-04
Submitted:2008-05-12
Entered:2008-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2935AA / 2 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF355AA / 2 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0170-2 / 2 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B47442H / 2 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0968U / 1 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Appendicectomy, Intussusception, Surgery, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: 9/11/08-records received-Abdominal x-ray consistent with intussusception. Air contrast enema revealed obstruction at left side of bowel. Incomplete reduction by air contrast enema. two episodes of bilious emesis on 4/9/08. Abdominal US and x-ray and barium enema did not revealed repeat intussusception.
CDC 'Split Type':

Write-up: 4/4/08 Patient started having vomiting with every feeds. Initially diagnosed as gastroenteritis. Went to Emergency Dept 4/4/08, 4/6/08, and our office 4/7/08. Diagnosed with intussucsception 4/8/08. Unable to be reduced by radiology, and required surgery. Had surgery for intussusception 4/8/08 and appendectomy. 9/11/08-records received for DOS 4/8-4/14/08-DC DX:Intussusception status post reduction and appendectomy. Presented with 4 day history of vomiting after every feeding, crying and increased fussiness. Post operatively had increased distention and had NG tube placement after two episodes of bilious emesis on 4/9/08. Abdominal US and x-ray and barium enema did not revealed repeat intussusception. NG removed tolerating fluids.

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=312127&WAYBACKHISTORY=ON


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