National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 340169

Case Details

VAERS ID: 340169 (history)  
Form: Version 1.0  
Age: 0.5  
Sex: Male  
Location: New York  
Vaccinated:2008-12-22
Onset:2009-02-06
   Days after vaccination:46
Submitted: 2009-02-10
   Days after onset:4
Entered: 2009-02-20
   Days after submission:10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B079 / 3 LL / UN
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR UT2787AA / 1 RL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 808702K / 3 RL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0924X / 3 MO / PO

Administered by: Private       Purchased by: Private
Symptoms: Intussusception
SMQs:, Gastrointestinal obstruction (narrow)

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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None PMH: Currently w/OM & being tx w/oral antibiotics. Family Hx: celiac disease, intussusception & lactose intolerance.
Allergies:
Diagnostic Lab Data: LABS: Abdominal x-ray & KUB abnormal. Segs 47%(H), plts 457(H). Creatinine 8(L), albumin 5.0(H), globulin 2.1(L), AST 42(H).
CDC Split Type:

Write-up: Admitted to hospital 2/6/9 for intussusception. 3/9/09 Received hospital medical records of 2/6-2/7/2009. FINAL DX: Ileocecal intussusception Records reveal patient experienced irritability, abdominal pain, curling up in a ball then sleeping immediately after. Vomited at daycare & in evening had bloody stool. Taken to ER where dx w/IS & enema reduced. Admitted overnight for observation, did well & d/c to home.


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=340169


Copyright © 2020 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166