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This is VAERS ID 385742

Case Details

VAERS ID: 385742 (history)  
Form: Version 1.0  
Age: 0.49  
Sex: Female  
Location: California  
Vaccinated:2010-03-22
Onset:2010-04-04
   Days after vaccination:13
Submitted: 2010-04-22
   Days after onset:18
Entered: 2010-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3324AA / 3 RL / UN
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB818AA / 3 RL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D93211 / 3 LL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1521Y / 3 MO / PO

Administered by: Public       Purchased by: Public
Symptoms: Intestinal ischaemia, Intestinal resection, Intussusception, Surgery
SMQs:, Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal obstruction (narrow), Ischaemic colitis (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Intussusception dx''ed 4/6/10, with 10 cm ischemic bowel removed. Good recovery.


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