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This is VAERS ID 323815

(NOTE: This result is from the 9/14/2018 version of the VAERS database)

Case Details

VAERS ID: 323815 (history)  
Form: Version 1.0  
Age: 0.54  
Sex: Female  
Location: Virginia  
Vaccinated:2007-07-19
Onset:2008-08-22
   Days after vaccination:400
Submitted: 2008-08-23
   Days after onset:1
Entered: 2008-09-01
   Days after submission:9
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C25700AA / 3 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UE965AA / 3 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B588458 / 3 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1233F / 3 MO / PO

Administered by: Private       Purchased by: Unknown
Symptoms: Enema administration, Intussusception
SMQs:, Gastrointestinal obstruction (narrow)

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? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: ER - Admitted 9/3/08-records received-Stool culture negative. US revealed ileocolic intussusception at level of hepatic flexure.
CDC Split Type:

Write-up: ? Intussusception w/successful reduction by air enema 8/22/08. 9/3/08-records received for DOS 8/21/08-DX:Intussusception with successful reduction by air enema of US revealed ileocolic intussusception at level of hepatic flexure. Presented to ED with C/O bloody diarrhea with blood and mucus noted in diaper. Fever 103 and decreased appetite. Lethargy. Abdominal cramping. Just returned 2 days prior from another country.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20180914&IDNUMBER=323815


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