National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 545805

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

Case Details

VAERS ID: 545805 (history)  
Form: Version .0  
Age: 0.18  
Gender: Male  
Location: Illinois  
Vaccinated:2014-09-18
Onset:2014-09-26
   Days after vaccination:8
Submitted: 2014-09-30
   Days after onset:4
Entered: 2014-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4537AAC4502AA / 0 LL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. J007946 / 1 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH H86640 / 0 LL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41CB430A / 0 - / PO

Administered by: Unknown       Purchased by: Private
Symptoms: Enema administration, Intussusception, Ultrasound abdomen abnormal, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Ultrasoud: intussusception on 9/26/14 at hospital; transferred to another hospital for peds radiology reduction by enema
CDC Split Type:

Write-up: Vomiting for one day; intussusception diagnosed.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20170214&IDNUMBER=545805


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