This is VAERS ID 316703
| Days after vaccination:||22
| Days after onset:||6
| Days after submission:||4
|Vaccination / Manufacturer
||Lot / Dose
||Site / Route|
|DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS
||AC21B142AA / 2
||RL / IM
|PNC: PNEUMO (PREVNAR) / PFIZER/WYETH
||C65047 / 2
||RL / IM
|RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC.
||0018 / 2
||MO / PO
Administered by: Public Purchased by: Public
Symptoms: Enema administration,
SMQs:, Gastrointestinal obstruction (narrow)
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
Extended hospital stay? No
Other Medications: None
Current Illness: None 7/23/08-records received-HX of runny nose and cough for 2 days.
Preexisting Conditions: None 7/23/08-records received-PMH:lactose intolerance, soy formula. April 08, Ear infections and treated with Amoxicillin which caused bloody diarrhea.
Diagnostic Lab Data: Abdominal air/air enema reduction at hospital. 7/23/08-records received-Air enema successful reduction of intussusception ileo-colic. Potassium 5.4, stool for occult blood negative. WBC 16.7, chem 7 WNL.
CDC Split Type:
Write-up: ROTATEQ #3 given on 5/19/08. On 6/10/08 pt diagnosed with intussusception. Treated at hospital. 7/23/08-records received for DOS 6/10/08-Presented with C/O irritability and intermittent crying since 3:00 am. Vomited. No bowel movement since 6/8/08. Subsequently had BM in hospital. PE: bowel sounds present. 7/23/08-DC records received for DOS 6/10-6/12/08-DC DX:Intussusception. Status post reduction of intussusception with air enema.
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