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This is VAERS ID 396263

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

Case Details

VAERS ID: 396263 (history)  
Form: Version .0  
Age: 0.18  
Gender: Female  
Location: South Carolina  
Vaccinated:2010-08-09
Onset:2010-08-14
   Days after vaccination:5
Submitted: 2010-08-18
   Days after onset:4
Entered: 2010-08-23
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3682A / 0 LL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1484Y / 1 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH E61989 / 0 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB05 / 0 - / PO

Administered by: Private       Purchased by: Private
Symptoms: Barium double contrast, Enema administration, Intussusception, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Air contrast barium enema
CDC Split Type:

Write-up: Intussusception =$g vomiting 8 days after vaccines; air contrast barium enema diagnosed and reduced intussusception.


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http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20170214&IDNUMBER=396263


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