This is VAERS ID 315579

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

Case Details

VAERS ID:	315579 (history)
Form:	Version .0
Age:	0.5
Gender:	Male
Location:	North Carolina

Vaccinated:	2008-05-30
Onset:	2008-06-03
Days after vaccination:	4
Submitted:	2008-06-04
Days after onset:	1
Entered:	2008-06-09
Days after submission:	5

Vaccination / Manufacturer	Lot / Dose	Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS	AC21B142AA / 2	RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR	UF350AA / 2	LL / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC	C65929 / 2	LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC.	0211X / 2	- / PO

Administered by: Private Purchased by: Private
Symptoms: Appendicectomy, Intussusception, Laparoscopy
SMQs:, Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad)

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, 1 days
Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: TYLENOL
Current Illness: hematochezia
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Intussusception, surgical intervention. 7/23/08-follow up visit for DOS 6/18/08-seen for routine follow up after laparoscopic reduction of intussusception and appendectomy. Presented with nonreducible intussusception with uneventful recovery.

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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20091208&IDNUMBER=315579