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This is VAERS ID 326527

(NOTE: This result is from the 4/7/2010 version of the VAERS database)

Case Details

VAERS ID: 326527 (history)  
Form: Version .0  
Age: 0.2  
Sex: Male  
Location: California  
Vaccinated:2008-07-30
Onset:0000-00-00
Submitted: 2008-09-29
Entered: 2008-09-30
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / - UN / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. - / - UN / UN
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / - UN / UN
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC - / - UN / UN
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0210X / 0 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Intussusception, Surgery
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, 0 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0809USA04296

Write-up: Information has been received from a physician concerning a male who on 30-JUL-2008 was vaccinated with the first dose of ROTATEQ (lot #660681/0210X). Concomitant suspect vaccine therapy included a dose of PEDVAXHIB (manufacturer unknown) and a dose of RECOMBIVAX HB (manufacturer unknown). Other concomitant vaccine therapy included a dose of DTAP, IPOL and a dose of PREVNAR. It was reported that the patient was admitted to the hospital and operated on immediately for intussusception (on an unspecified date between 30-JUL-2008 and 24-SEP-2008). The patient has recovered (date not reported). Additional information has been requested.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20100407&IDNUMBER=326527


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