National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 380464

(NOTE: This result is from the 4/13/2011 version of the VAERS database)

Case Details

VAERS ID: 380464 (history)  
Form: Version .0  
Age: 0.3  
Sex: Male  
Location: California  
Vaccinated:2010-01-18
Onset:2010-01-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2010-02-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3564AA / 1 UN / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D67170 / 1 UN / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0574Y / 1 - / PO

Administered by: Private       Purchased by: Private
Symptoms: Barium enema, Diarrhoea, Full blood count normal, Haematochezia, Intussusception, Irritability, Laboratory test normal, Ultrasound abdomen abnormal, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal haemorrhage (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Ischaemic colitis (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: Vomited twice day prior and once this morning
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: abd u/s positive with intussusception
CDC Split Type:

Write-up: Intussusception on 1-19-10. Had Barium enema and it resolved.


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20110413&IDNUMBER=380464


Copyright © 2019 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166