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This is VAERS ID 383135

(NOTE: This result is from the 5/13/2013 version of the VAERS database)

Case Details

VAERS ID: 383135 (history)  
Form: Version .0  
Age: 0.5  
Gender: Male  
Location: New York  
Vaccinated:2010-03-15
Onset:2010-03-19
   Days after vaccination:4
Submitted: 2010-03-22
   Days after onset:3
Entered: 2010-03-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3555AA / 1 LL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. AHBVB818BA / 3 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D94434 / 1 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB036A / 1 - / PO

Administered by: Private       Purchased by: Public
Symptoms: Aspartate aminotransferase increased, Barium double contrast, Blood creatinine decreased, Blood culture negative, Carbon dioxide decreased, Culture stool negative, Diarrhoea, Full blood count, Haematemesis, Haematocrit decreased, Haemoglobin decreased, Intussusception, Metabolic function test, Platelet count increased, Pyrexia, Red blood cell count decreased, Stool analysis abnormal, Vomiting
SMQs:, Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Haematopoietic erythropenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: intussusception


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20130513&IDNUMBER=383135


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