National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 439014

(NOTE: This result is from the 11/14/2011 version of the VAERS database)

Case Details

VAERS ID: 439014 (history)  
Form: Version .0  
Age: 0.2  
Gender: Male  
Location: New York  
Vaccinated:2011-10-12
Onset:2011-10-16
   Days after vaccination:4
Submitted: 2011-10-19
   Days after onset:3
Entered: 2011-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B305BA / 0 LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0254AA / 0 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 916617 / 0 RL / IM
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB16CA / 0 - / PO

Administered by: Private       Purchased by: Public
Symptoms: Full blood count, Intussusception, Metabolic function test, Ultrasound scan, X-ray
SMQs:, Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad)

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: Had viral exanthem on 10/5/11
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: CBC; BMP; X-ray; Ultrasound
CDC Split Type:

Write-up: On 10/16/11 pt seen in ER with intussusception. Transferred.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20111114&IDNUMBER=439014


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