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This is VAERS ID 385949

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

Case Details

VAERS ID: 385949 (history)  
Form: Version .0  
Age: 0.17  
Gender: Male  
Location: Nebraska  
Vaccinated:2010-03-01
Onset:2010-04-24
   Days after vaccination:54
Submitted: 2010-04-26
   Days after onset:2
Entered: 2010-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3606AA / 0 UN / IM
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB772CA / 1 UN / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH E20366 / 0 UN / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41DB036A / 0 - / PO

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

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: intussusception~Rotavirus (Rotarix)~1~0.00~Patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Fluoro Barium Enema and ultra sound
CDC Split Type:

Write-up: Infant was admitted to hospital with intussusception on 4/24/10.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20170214&IDNUMBER=385949


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