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This is VAERS ID 465859

(NOTE: This result is from the 2/14/2017 version of the VAERS database)

Case Details

VAERS ID: 465859 (history)  
Form: Version .0  
Age: 0.18  
Gender: Male  
Location: Kentucky  
Vaccinated:2012-08-06
Onset:2012-08-13
   Days after vaccination:7
Submitted: 2012-09-20
   Days after onset:38
Entered: 2012-09-21
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4257AA / 0 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0021AE / 1 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH E562922 / 0 LL / UN
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB252A / 0 - / PO

Administered by: Private       Purchased by: Public
Symptoms: Appendicectomy, Haematochezia, Intussusception, Nausea, Ultrasound scan, Vomiting, X-ray
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ultrasound; X-ray
CDC Split Type:

Write-up: Nausea & vomiting, blood in stool. Open reduction of ileocolic intuss with incidental appendectomy.


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Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20170214&IDNUMBER=465859


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