National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 431215

Case Details

VAERS ID: 431215 (history)  
Form: Version 1.0  
Age: 0.16  
Gender: Male  
Location: Ohio  
Vaccinated:2011-08-15
Onset:2011-08-23
   Days after vaccination:8
Submitted: 2011-08-25
   Days after onset:2
Entered: 2011-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B285EA / 1 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH E88940 / 1 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS AU1FB162A / 1 MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Abdominal X-ray, Ascites, Enema administration, Intussusception, Obstruction, Ultrasound abdomen abnormal, X-ray abnormal
SMQs:, Liver related investigations, signs and symptoms (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal obstruction (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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, 2 days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: Abdominal x ray: air fluid levels abdominal ultrasound: obstruction, ascites, intussusception barium enema: air enema reduced ileocolic intussusception
CDC Split Type:

Write-up: ileocolic Intussusception


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=431215


Copyright © 2018 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166