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This is VAERS ID 261949

(NOTE: This result is from the 9/14/2017 version of the VAERS database)

Case Details

VAERS ID: 261949 (history)  
Form: Version 1.0  
Age: 0.35  
Gender: Unknown  
Location: Texas  
Vaccinated:2006-07-18
Onset:2006-08-10
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2006-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B056AA / 2 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B086560 / UNK RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0139F / 1 MO / PO

Administered by: Private       Purchased by: Unknown
Symptoms: Apnoea, Intussusception, Pyrexia, Urinary tract infection, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal obstruction (narrow), Acute central respiratory depression (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Received rotavirus shot 7/18/06. Diagnosed with Intussusception 8/10/06. Medical record states apnea, urinary tract infection, vomiting, fever. msv


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