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This is VAERS ID 495671

(NOTE: This result is from the 9/17/2013 version of the VAERS database)

Case Details

VAERS ID: 495671 (history)  
Form: Version .0  
Age: 0.3  
Gender: Male  
Location: Michigan  
Vaccinated:2013-05-13
Onset:2013-06-27
   Days after vaccination:45
Submitted: 2013-07-02
   Days after onset:5
Entered: 2013-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4359AA / 1 UN / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH G75071 / 1 UN / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB346A / 1 - / PO

Administered by: Private       Purchased by: Private
Symptoms: Abdominal X-ray, Barium enema, Condition aggravated, Dehydration, Intussusception, Irritability, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Gastrointestinal obstruction (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Mild URI; Mild ROM; Vomiting day before
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Abdominal X-ray; Barium enema
CDC Split Type:

Write-up: 6.27.13 started with vomiting; 6.28.13 vomiting and very fussy, dehydrated. Sent to hospital for evaluation and IV rehydration. Intussusception diagnosed and treated by barium enema.


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Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20130917&IDNUMBER=495671


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